Role of Endoscopy to Define Postoperative Recurrence in IBD

Despite new medical treatments for inflammatory bowel disease, surgical resection remains a cornerstone of therapy. Unfortunately, recurrence of inflammation after surgery is common in both Crohn’s disease and ulcerative colitis. After surgical resection, endoscopic evidence of inflammation recurs in the great majority of Crohn’s disease patients and its severity predicts the recurrence of symptomatic disease so that appropriate therapy can be initiated in time to prevent complications. Following total proctocolectomy and ileoanal pouch anastomosis for ulcerative colitis, inflammation can occur in the form of cuffitis, pouchitis or Crohn’s disease of the pouch. The following chapter illustrates the role of endoscopy in diagnosing and guiding management of post-surgical inflammation in inflammatory bowel disease.