Surgery rates for Crohn's

[KB24]

From what I read here it is 75% but just out of curiosity would like your input on likelihood of surgery / potential prevention steps for surgery / experiences and what type of surgery was performed?

Thanks.

 

[Tuff]

In five years, I've had one surgery, to clean out an abscess that had already burst. I had fistulas, but never had surgery on them. They closed with Remicade. Potential prevention, I would suggest to take your medications as prescribed, if and when they stop working, try something else until you find a combo that works. Stay away from your food triggers. Eat healthy, get enough sleep, and reduce the stress in your life. Take charge of your health. I've lived a pretty normal life. :ghug:

 

[ronroush7]

I had two surgeries in 1989, one for hemorrhoids and one for a fistula. In 1992, I had an abscess drained twice. Two years later, I had surgery for a fistula. Six years ago , I had a bowel resection. I would agree with Tuff on his recommendations.

 

[Tuff]

I had two surgeries in 1989, one for hemorrhoids and one for a fistula. In 1992, I had an abscess drained twice. Two years later, I had surgery for a fistula. Six years ago , I had a bowel resection. I would agree with Tuff on his recommendations.

Her :tongue:

 

[KarenC]

The high surgery rate reflects, I believe, the highly variable nature of the disease and the number of surgeries over time for those who've had the disease for many years when there were far fewer treatment options. I have had Crohn's for over 40 years. I had two surgeries for anal fissures in 1979 and a subsequent surgery (lateral sphincterotomy) in a (successful) attempt to get the fissures to heal. I doubt these surgeries would be done today with other options available. I had a resection in 2008, due to decades of untreated disease that probably would have responded today's medications.

 

[Charlotte.]

I read (book from the 90's) that around 40 % require surgery after 5 years, so this book was before Remicade, Humira, Simponi, Entyvio, you name it.
I haven't come across current data that pays biologics into account. You would require to only focus on patients that have been treated with the top down strategy, so biologicals as soon as possible, directly after diagnosis, that could show a very different number.

75% is too high, to my mind, there are these guys who have 3 flares in their lives as well! And also those with constant inflammation but still without surgery, at least in my local support group. Would not bee to negative...

 

[Clash]

Surgery rates are high among those with CD

Between 70% and 90% of patients with Crohn's disease will require surgery during their lifetime,1,2 even those who first present with a nonfistulizing, nonpenetrating phenotype,3 and as many as 39% will require repeated surgery.4

Source

Unfortunately, surgery for Crohn's disease is the rule rather than the exception - at least 80% will require at least one surgical procedure over the first 5 years of disease and many will need multiple abdominal surgeries over their lifetime.

Source

CCFA:

About 70% of people with Crohn’s disease eventually require surgery.

Source

 

[Clash]

Also, early intro of biologics lessens the surgery risk to 30-45% percent in some studies.

 

[KB24]

Also, early intro of biologics lessens the surgery risk to 30-45% percent in some studies.

So If im on Imuran, and possibly getting a prescribtion for asocal as well should I trust my GI prescribing me to the right medication or push them to prescribe me biologics?

 

[Clash]

I don't have access to the studies of remicade use early in treatment affecting surgery rates. Also, I don't know that the studies give enough overwhelming results to affect treatment choice.

I'll tag my little penguin as she probably has a link to one of the studies involving early remicade intervention.

A large number of GIs do use the top down approach to therapy but step up therapy is still a treatment therapyramid that is used. The choice may depend on severity of disease or in pediatric patients the urgency to allow for normal growth during that critical age.

 

[hawkeye]

So If im on Imuran, and possibly getting a prescribtion for asocal as well should I trust my GI prescribing me to the right medication or push them to prescribe me biologics?

I was on this regime for over 20 years before I required surgery.

 

[Charlotte.]

I don't have access to the studies of remicade use early in treatment affecting surgery rates. Also, I don't know that the studies give enough overwhelming results to affect treatment choice.

I'll tag my little penguin as she probably has a link to one of the studies involving early remicade intervention.

A large number of GIs do use the top down approach to therapy but step up therapy is still a treatment therapyramid that is used. The choice may depend on severity of disease or in pediatric patients the urgency to allow for normal growth during that critical age.

Well, to be honest, the choice also differs largely from country to country and from health insurance for sure, I believe. Unfortunately it's not just about treating patients when it comes to a decision what drug might be the right one.

 

[KB24]

Well, to be honest, the choice also differs largely from country to country and from health insurance for sure, I believe. Unfortunately it's not just about treating patients when it comes to a decision what drug might be the right one.

Charlotte, I will be meeting my GI soon, so wondering how I can find out if these prescriptions are best for me rather than based on my health insurance.