Recommendation ID
CG152/4
Question
Surgery versus medical treatment for the distal ileum:- What is the effect on quality of life of medical treatment (immunosuppressive or biological therapy) compared with early surgery for Crohn's disease limited to the distal ileum?
Any explanatory notes
(if applicable)
Why this is important:- Patients first presenting with Crohn's disease limited to the distal ileum are usually treated medically. When relapse occurs there is the option of further medical treatment or surgery. Recurrence and reoperation rates are high after surgery, but most people with medically treated Crohn's disease require surgery at some time. There are no comparative studies reporting the quality of life associated with and long-term outcome of these management strategies. A multicentre trial is currently in progress in Holland in which patients with Crohn's disease limited to the distal ileum are randomised to treatment with a biological agent or laparoscopic surgical resection at the point at which initial medical treatment fails. A similar trial should be carried out in the UK, also considering the effectiveness of azathioprine as a medical treatment option.

Source guidance details

Comes from guidance
Crohn's disease: management
Number
CG152
Date issued
October 2012

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 25/10/2012