Crohn's disease is characterized at...

Crohn's disease is characterized at asymptomatic periods with episodic worsening of symptoms. Treatment aims to decrease relapse rate and/or minimize symptoms. auspicious treatment is measured by improved quality of life and reduc disruptions of daily routine. mostly patients with Crohn's disease have at least single surgical procedure during their lifetime, and surgery increases the likelihood of requiring further surgery However, the impact of surgery forward quality of life may help patients make decisions about operations. Delaney and associates studied preoperative and postoperative quality of life in 82 patients who had surgery for Crohn's disease.

The authors used the Cleveland Global Quality of Life (CGQL) score, which has been validated in Crohn's disease. Participants complet the CGQL before surgery and again 30 days after the operation Surgery was elective in 78 of the patients. Postoperatively, major complications occurr in 19 patients (23 percent)

The CGQL showed significant improvement 30 days after surgery with 54 patients showing improvement, eight showing no change, and 20 showing a worse CGQL score. Sixty-five patients said they would bear surgery again if they were in a position to pitch upon Independent predictors of greater improvement in postoperative CGQL included female sex and absence of postoperative complications, while use of steroids at the time of surgery was associated with greater improvement.

The authors gather that surgery improved quality of life in patients with active Crohn's disease or Crohn's disease in remission. The likelihood of positive issues increased among women and among those who did not have any postoperative complications, and was not affected by way of other patient characteristics, nature of disease, indication for surgery act performed, or nature of complications. Many patients said they would cull surgery again if they had the choice.

RICHARD SADOVSKY, MD

Delaney CP et al. Quality of life improves within 30 days of surgery for Crohn's disease. J Am Coll Surg May 2003;196:714-21

COPYRIGHT 2003 American Academy of Family Physicians

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