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Crohn's-Related Surgery Risk in Children Rarer Than Thought

Immunomodulator therapy within 30 days appears not to influence bowel surgery risk

THURSDAY, Sept. 9 (HealthDay News) -- The risk of bowel surgery in pediatric Crohn's disease (CD) patients appears to be lower than previously reported, and early initiation of immunomodulators does not appear to influence the risk of bowel surgery, according to research published in the September issue of Clinical Gastroenterology and Hepatology.

Marc E. Schaefer, M.D., of Rhode Island Hospital in Providence, and colleagues studied data collected on 854 children with CD diagnosed between 2002 and 2008 to determine the incidence of CD-related surgery and the effect of immunomodulator therapy started within 30 days of diagnosis.

The researchers found that 76 (9 percent) had a first CD-related surgery, 57 (7 percent) had a first bowel surgery, and 19 (2 percent) had a first non-bowel surgery. The cumulative risks for surgeries at one year and five years after diagnosis were, respectively, 3.4 and 13.8 percent for bowel surgery, 1.4 and 4.5 percent for non-bowel surgery, and 4.8 and 17.7 percent for all CD-related surgeries. Use of immunomodulator therapy within 30 days of diagnosis did not appear to have an impact on the risk of bowel surgery. The authors note that the five-year cumulative risk of bowel surgery was lower than that recently reported in studies of adult and pediatric patients.

"In summary, we have identified older age at diagnosis, greater disease severity, stricturing disease, and penetrating disease to be associated with an increased risk for bowel surgery, and disease located between the transverse colon and rectum to be associated with a decreased risk for bowel surgery. There is a lower risk of bowel surgery for this pediatric cohort compared with previous studies that have included adults and children," the authors write.

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