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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

438
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
438
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

471
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
471
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

478
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
478
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

425
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
425
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence01:22

Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence

177
Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
177
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

480
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
480

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Related Experiment Video

Updated: Jan 13, 2026

Murine Ileocolic Bowel Resection with Primary Anastomosis
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Biologics Before Surgery Are Not Associated With Complications After Surgery for IBD: A National Surgery Quality

Stefan D Holubar1, Tara Russell2, Nicholas Neel3

  • 1Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Diseases of the Colon and Rectum
|January 6, 2026
PubMed
Summary

Preoperative exposure to biologics before inflammatory bowel disease surgery is safe. Biologic use within 60 days of surgery did not increase postoperative adverse events or complications in patients with inflammatory bowel disease.

Keywords:
Anastomotic leakBiologicsColectomyCrohn’s diseaseIleoanal pouchIleostomyInfectious complicationsProctectomySurgeryUlcerative colitis

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Immunology

Background:

  • The safety of preoperative biologic exposure in inflammatory bowel disease (IBD) patients undergoing surgery is debated.
  • Existing research on the association between perioperative biologics and surgical outcomes in IBD is controversial.

Purpose of the Study:

  • To investigate the safety of biologic exposure within 60 days of surgery for IBD.
  • To determine if biologic use increases postoperative adverse events in IBD patients.

Main Methods:

  • A multicenter national cohort study included adult IBD patients from 24 centers (2020-2024).
  • The study analyzed postoperative adverse event rates within 30 days, focusing on infectious and overall complications.
  • Propensity score-based causal inference modeling was used to assess the impact of biologic exposure within 60 days of surgery.

Main Results:

  • Of 2,926 patients, 48.8% received preoperative biologics.
  • The biologic group had different preoperative characteristics and intraoperative details, including shorter operative times and more minimally invasive procedures.
  • Inverse probability treatment weighting showed no association between biologics and increased postoperative infections (RR 0.97), complications (RR 0.92), or adverse events (RR 0.92).

Conclusions:

  • Preoperative biologic exposure within 60 days of IBD surgery is not linked to increased postoperative adverse outcomes.
  • These findings suggest that using biologics before IBD surgery is safe and does not elevate short-term adverse outcomes.
  • Limitations include generalizability, potential selection bias, unmeasured confounders, and the defined 60-day biologic exposure window.