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Thiopurines halve risk of repeat Crohn's disease surgery

http://www.ccfa.org/reuters/Thiopurines

"NEW YORK (Reuters Health) - After a first surgical resection for Crohn's disease, long-term treatment with thiopurines appears to cut the risk of subsequent intestinal surgery by nearly 60%, Austrian researchers reported online December 15th in the American Journal of Gastroenterology.

They were "facing a situation where evidence on the influence of azathioprine and 6-mercaptopurine on the natural course of Crohn's disease in adult patients is controversial," the researchers said. Therefore, they reviewed the outcomes of 326 patients who had surgery for Crohn's disease, 161 of whom (49%) had taken either azathioprine or 6-mercaptopurine postoperatively.

As co-author Dr. Walter Reinisch of the Medical University of Vienna and colleagues report, 151 patients (46.3%) had surgery for recurrent disease at a median of 71 months after the initial operation.

Overall, 38.5% of the thiopurine group had surgical recurrence, significantly fewer than the 53.9% in the non-treatment group. Patients treated with thiopurines for at least 36 months were at significantly lower risk for more surgery compared to those who had received shorter treatment or no treatment (hazard ratio, 0.41, p < 0.004)."

"The researchers also examined the influence of smoking in the 273 patients with available data. At a median of 11.5 years, the 139 smokers in the group had an increased risk of surgical recurrence compared with the 134 non-smokers (HR, 1.6, p < 0.008)."



I had surgery about 2 and a half months ago, but was put on no meds since my liver cannot tolerate Imuran. So I'll just have to take my risks with no meds, and pray to God it never comes back :)
 
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Crohn's 35

Inactive Account
I am with you Mazen. I cannot take any immunosuppressants. My Gi says Imuran and Flagyl ( our most hated drug lol) for 4 months is supposed to keep it at bay. I see you are taking probiotics, you can't over do on those, so it could help.

I assume you are doing well Mazen? Don't see you on here much ;).
 
Hi Pen. i am still doing fine, but have some mild mascular pains on the right side extending from my lower back to the thigh. don't know if it's Crohn's or surgery related, and the odd pian in the surgery site. I will check with the doctor when I see him again.

What about you? Hope you are doing well these days.....
 

Crohn's 35

Inactive Account
Thanks for asking Mazen, but I am up and down, mostly going up. The methotrexate takes a while to kick in, and tapering to 10mg this Saturday. But for the most part, I am doing well. Maybe you have IBS? I have had Crohns for years but my Gi thinks I have IBS, taking the odd antispasmotic. Hope you heal really fast. Let us know what your doc says ok? Take care!
 
glad things are going well for you after the surgery Mazen.

I have been doing fantastic myself and I am back to where my life was before crohn's put me on the side lines. Perhaps even a bit better as the weight seems to be easier to keep on.

I am taking still taking175mg Imuran and will not meet with the Disease management team again until September. Not only do I feel good, I have relaxed the restrictions on my diet and I do not need any type of Arthritis medication for the first time in a long time. Imuran has removed the aches and pains in my lower legs and even helped to moderate pesky allergic reactions I have had since I was a child. I feel quite lucky with how things are going for me and I think I will go find some wood to knock on in hopes of keeping it that way :)
 
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