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  • 1 Csolnoky Ferenc Megyei Kórház Belgyógyászati Centrum Veszprém Kórház u. 1. 8200
  • 2 Semmelweis Egyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Budapest

A Crohn-betegség krónikus, progresszív kórkép, amely évek alatt az esetek többségében stenotisáló vagy penetráló szövődményekhez vezet. A betegség súlyos aktivitása vagy a szövődmények miatt az esetek mintegy 70%-ában reszekciós műtétre van szükség. A betegség azonban csaknem mindig kiújul, sokszor újabb műtétet igényel. A posztoperatív kiújulás megelőzése nem megoldott, biztosan hatékony szereink nincsenek. Gondos kockázatfelmérés alapján egyedileg kell minden esetben dönteni a kiújulás rizikója és a kezelés előnyeinek, veszélyeinek mérlegelésével. Az alacsony kockázatú esetekben mesalazin adása jön szóba, de a kezelés mellőzése is elfogadható alternatíva. Súlyosabb esetekben immunszuppresszív szer, elsősorban azathioprin adása indokolt. Ígéretesnek tűnik a műtét után három hónapig metronidazol szedése, valamennyi betegcsoportban. A műtét után 6–12 hónappal végzett ileocolonoscopos vizsgálattal objektív képet kaphatunk a betegség endoszkópos súlyosságáról, amelynek prediktív értéke van a későbbi klinikai lefolyás vonatkozásában, ezáltal irányjelzőként szolgálhat a kezelés számára. A legsúlyosabb esetekben az anti-TNF-szerek jelenthetik a hatékony prevenciót és kezelést.

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