Perioperative use of NSAIDs and the risk of short-term endoscopic recurrence in Crohn's disease patients: A retrospective cohort study

• Published in: The American journal of surgery Vol. 225; no. 6; pp. 1045 - 1049
• Main Authors: Gaytan-Fuentes, Israel A., Ore, Ana Sofia, Vigna, Carolina, Cordova-Cassia, Carlos A., Crowell, Kristen T., Fabrizio, Anne C., Cataldo, Thomas E., Messaris, Evangelos
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2023; Elsevier Limited
• Subjects: Abdomen; Anastomosis; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Cohort analysis; Colectomy - adverse effects; Colon - surgery; Colonoscopy; Colorectal surgery; Crohn Disease - drug therapy; Crohn Disease - surgery; Crohn's disease; Crohns disease; Drug dosages; Endoscopy; Enzymes; Humans; Ileum - surgery; Inflammatory bowel disease; Length of stay; Narcotics; Nonsteroidal anti-inflammatory drugs; Ostomy; Patients; Postoperative period; Recovery (Medical); Recurrence; Retrospective Studies; Risk factors; Surgical anastomosis
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2022.12.003

More evidence is needed on the use of NSAID based postoperative pain regimens for Crohn's disease (CD) and its association with recurrence. Our goal is to assess the impact of perioperative use of NSAIDs on endoscopic disease recurrence in patients with CD. A retrospective cohort study was conducted. The primary outcome measured was endoscopic disease recurrence within 24 months of surgery, defined as a Rutgeerts score ≥ i2. We identified 107 patients with CD that underwent index ileocolectomy with primary anastomosis between January 2009 and July 2019. Endoscopic disease recurrence was identified in 28 (26.2%) and clinical recurrence in 18 (16.8%) patients. Exposure to NSAIDs did not increase 24-month endoscopic recurrence risk (22.2% vs. 38.5% patients, p = 0.12). In patients with CD undergoing elective ileocolic resection and primary ileocolic anastomosis, NSAID use in the perioperative period did not impact endoscopic or clinical disease recurrence rate. •Perioperative use of NSAIDs was not associated with an increased risk of endoscopic disease recurrence after ileocolectomy.•There was no difference in clinical recurrence rates between those exposed and non-exposed to NSAIDs.•NSAIDs appear to be safe to use as part of an accelerated pathway for recovery following surgery for CD.