Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

David T Rubin, MD; Sonia Friedman, MD; Francis A Farraye, MD MSc

Question 37: How Does Perioperative Immune Suppression Affect Surgical Outcomes In Inflammatory Bowel Disease? (continued)

Liliana Bordeianou, MD; Richard Hodin, MD

Approximately 80% of patients with Crohn’s disease (CD) and 30% with ulcerative colitis (UC) will eventually require surgical intervention, most commonly due to failure of medical management. In general, by the time a patient sees a surgeon, he or she has already advanced past 5-aminosalicylic acid (5-ASA) agents to immunomodulator treatments (eg, 6-mercaptopurine [6-MP], azathioprine [AZA], and anti-tumor necrosis factors [TNFs]); many will also be taking immunosuppressants (eg, steroids and cyclosporine). Some of these patients are malnourished, and some with CD may…