摘要
The natural history of Crohn’s disease(CD)dictates that patients re-quire long-term medical therapy for induction and maintenance to relieve their symptoms,improve health-related quality of life,pre-vent tissue damage,lessen the risk for neoplasia,and reduce hospi-talization and surgery.For the past quarter of a century,medical management of CD has evolved from corticosteroids for induction and immunomodulators formaintenance to antitumor necrosis fac-tor,anti-integrin,and anti-interleukin biological agents and,in the near future,small molecule agents,for both induction and mainte-nance.Despite advances inmedical therapy,themajority of patients with CDwould eventually require surgerywith incision and drainage of abscesses and fistulas,bowel resection and anastomosis,strictur-eplasty,or fecal diversion.Surgery will reset the clock for the disease course of CD and most patients require post-operative medical ther-apy to prevent disease recurrence.Colonoscopy plays a key role in disease monitoring and assessment of treatment response before and after surgery.Endoscopy also plays an important role in the treatment of CD-or its surgery-associated structural complications,such as primary or anastomotic strictures,abscesses,and fistulas.
