G&H How common are endoscopic recurrence and clinical recurrence of Crohn’s disease following surgery?
MR The simple answer is that both are common. Endoscopic recurrence refers to the appearance of ulcerations or inflammation representing Crohn’s disease on colonoscopy, usually within the first year after surgical treatment. Historically, in patients with Crohn’s disease who have been treated with surgery and have not started a postoperative medication, endoscopic recurrence has been reported in up to 90%, which is quite high. Clinical recurrence, on the other hand, involves the return of symptoms that represent active Crohn’s disease, and often a complication such as stenosis or penetrating disease. Usually within the first year of surgical treatment of Crohn’s disease, clinical recurrence can be quite low. Patients typically do not feel the endoscopic recurrence that occurs within the first year. Many patients are clinically silent until they start to develop more tissue damage, deeper ulcerations, or scarring. Historically, the clinical recurrence rate has been approximately 50% by 5 years after Crohn’s disease surgery.