Thread by @GroverDheera

@dunleavy_katie @MondayNightIBD @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 @ASGEendoscopy @PeyrinBiroulet @BrunoSilva_MD @MatFume 7/⬆️the risk of POR❓

Patient factors:
💎👨>👸
💎 >15 🚬/day
💎Young age at the time of ✂️ (<30 y)

Disease &💊factors:
💎Short disease duration before ✂️
💎>2 prior ✂️
💎Penetrating disease
💎SB resection >50 cm
💎➕ disease at resection margin
💎➖of post✂️ anti-TNF therapy

@dunleavy_katie @MondayNightIBD @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 @ASGEendoscopy @PeyrinBiroulet @BrunoSilva_MD @MatFume 8/⬇️the risk of POR❓

🧬Older patient (>50 y)
🧬Nonsmoker
🧬1st Sx for a short segment of fibrostenotic disease (<10 to 20 cm)

#B2BPearl #MondayNightIBD No difference in recurrence between Eastern and Western countries‼️

Take a look!

pubmed.ncbi.nlm.nih.gov/30126030/

@dunleavy_katie @MondayNightIBD @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 @ASGEendoscopy @PeyrinBiroulet @BrunoSilva_MD @MatFume 9/💎How to⬇️ POR risk?💊✂️
#B2BPearl Risk stratify pt & manage accordingly

💊Post-op
👉Nitroimidazole x3mos, if low risk
👉TNFi, start wk4, if high risk

✂️Kono-S anastomosis + extended mesenteric resection
🔦CLN at 6mos, adjust Rx per Rutgeerts score

pubmed.ncbi.nlm.nih.gov/34977147/

@dunleavy_katie @MondayNightIBD @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 @ASGEendoscopy @PeyrinBiroulet 10/ Let's recap #MondayNightIBD #Back2Basics

✴️Risk of🔦POR ~90% @1yr
✴️Do NOT Rely on sympt, recurrence often clinically silent
✴️Risk stratify to decide post-op Rx
✴️High risk: start TNFi
✴️Low risk: No tx/Nitroimidazole x3mos
✴️CLN @6mos & Adjust Rx per Rutgeerts score

@dunleavy_katie @MondayNightIBD @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 @TwittyWhitty22 @TAlbarraq @ibdmd_kaur @mikifreund @rtamerisa1 @IBD_DrEMF @SunnyOhSon @JennaIBDnurse @spthompsonmsn @mbanegasMD @AchuoEgbeMD @IBDGastroDocSg @DrPeeyushK @purnie_mae @yaransarkis @SchwartzbergMD @VVigorita @aotaib1 @a_bham18 @ralvrabie @JuanitaBelton1

@dunleavy_katie @MondayNightIBD @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 @TAlbarraq @ibdmd_kaur @mikifreund @rtamerisa1 @thamertraiki @Kpmollen @SamirGadepalli @DrJorgedeLeon @evanmessaris @pakotze @PatricioIbanez @JGubatanMD @JohnRTMonsonMD @Dr_Alessandra_G @bottomdoc @Uk_BowelDoc @DrChrisMoran @beingIBDdoc @Reza_GholamiMD @SamZullowMD @RocioSedanoMD