Perioperative management in patients with inflammatory bowel disease

Abstract

Although various medical treatments are recently available for patients with inflammatory bowel disease, some pa-tients remain refractory to current therapeutic strategies such as systemic steroid treatment, immunosuppresives, or treatment with biologics. High-dose perioperative steroids were previously considered the standard of care for steroid-treated patients undergoing major colorectal surgery but it is recently considered doses of steroids in the perioperative period should be determined based on the magnitude of surgical stress. Surgery for inflammatory bowel disease is frequently performed in patients with factors suspected of increasing the risk of postoperative com-plications especially postoperative infectious complications, such as concomitant active inflammation, impaired nutri-tional status, and chronic therapy with immunosuppressives. Many studies reported preoperative use of high dose of steroids in patients with inflammatory bowel disease undergoing abdominal surgery is associated with an increased risk of postoperative complications.