Thread by @dunleavy_katie

@MondayNightIBD 1/📢#GITwitter"There are two main mistakes in treating #IBD pts - the undertreatment and the overtreatment"-Prof #Rutgeerts!

Let’s talk about surgery & post-op surveillance in #crohns

@GroverDheera and I will #MakeItSimple in prep for #MondayNightIBD w @BattatMD4IBD @DCharabaty

@MondayNightIBD @GroverDheera @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek 2/ #MondayNightIBD
Journey of #Crohns disease:
🎢 Relapses & remission
🔥 Inflamm can leads to fibrostenosis, fistula and abscess
🚧 25% have complications at dx
✂️ 26% require surgery despite biologics

@MondayNightIBD @GroverDheera @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek @BettenworthDb @MaiaKayalMD @IBD_FloMD @APandT @debby_keller @ibdseb @IBDJournals @ezzatali64 @PracUpGastro @TwittyWhitty22 3/ Today’s focus is on surgery for #Crohns ileal #stricture

🌟 Indications: obstructive symptoms, stricture associated with abscess, suspicion of malignant stricture
🪄 Surgery🚫curative : #Crohns often recurs above IC anastomosis

#MondayNightIBD #Back2Basics

@MondayNightIBD @GroverDheera @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek @BettenworthDb @MaiaKayalMD @IBD_FloMD @APandT @debby_keller @ibdseb @IBDJournals @ezzatali64 @PracUpGastro @TwittyWhitty22 4/#MondayNightIBD #Back2Basics
Feeling better after Sx✂️ for ileal #CD, now what?

👇🏽Without prophylactic RX, post-op recurrence (POR) & timeline🔮

🔦90% endo recurrence @1yr
😡30% clinical sx @3yr, 60% @5yr
💉45% require rx escalation @5yr
✂️50% require another resection @5yr

@MondayNightIBD @GroverDheera @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek @BettenworthDb @MaiaKayalMD @IBD_FloMD @APandT @debby_keller @ibdseb @IBDJournals @ezzatali64 @PracUpGastro @TwittyWhitty22 @1yr @5yr @charlie_lees @P_DeepakIBDMD @EdwardLoftus2 @drvishal82 @guthealthmd @GuiRamosMD @MRegueiroMD @JanDabritz @MatthieuAllez 5/#MondayNightIBD #B2B
Dr. Rutgeerts was a ⭐️⭐️⭐️⭐️⭐️MD, researcher & mentor.

📊Presented on #CD POR 1982 @AmerGastroAssn
🏆#Rutgeerts score: findings in neoileum predict risk of dis progression & repeat Sx
🛑i2b-i3-i4 --> Start or adjust Rx
@AGA_Gastro doi.org/10.1053/j.gast…

@MondayNightIBD @GroverDheera @BattatMD4IBD @DCharabaty @JosephHabibi_MD @KanikaGargMD @Spencerkelley7 @BassiMehak @jalpa_devi @Empoweringpts9 @ayshaslam999 @RomyChamoun @JHaydek @BettenworthDb @MaiaKayalMD @IBD_FloMD @APandT @debby_keller @ibdseb @IBDJournals @ezzatali64 @PracUpGastro @TwittyWhitty22 @1yr @5yr @charlie_lees @P_DeepakIBDMD @EdwardLoftus2 @drvishal82 @guthealthmd @GuiRamosMD @MRegueiroMD @JanDabritz @MatthieuAllez @AmerGastroAssn @AGA_Gastro @ibdleuven @JeanFredericCo1 @SeverineVermei1 @GianlucaPellino @fgomollon @bverstockt @mchiorean4 @Gut_BMJ @BenClickMD @IBDcanruti 6/What's new since #Rutgeerts?

🔦Differentiate ulcers at IC anastomotic ring (i2a) vs neo-ileum (i2b)
✅i2a occur in 50% of ICA
✅i2a not associated w dis progression @ASGEendoscopy doi.org/10.1016/j.gie.…

🩺Non-invasive eval for #POR in #CD?
🩸CRP/💩FCP
🩻 MRE MONITOR Index