O abandono do hábito de fumar reduz as complicações apresentadas por pacientes e o risco de recorrência da doença.[212]Ryan WR, Allan RN, Yamamoto T, et al. Crohn's disease patients who quit smoking have a reduced risk of reoperation for recurrence. Am J Surg. 2004 Feb;187(2):219-25.
http://www.ncbi.nlm.nih.gov/pubmed/14769308?tool=bestpractice.com
[213]Nunes T, Etchevers MJ, García-Sánchez V, et al. Impact of smoking cessation on the clinical course of Crohn's disease under current therapeutic algorithms: a multicenter prospective study. Am J Gastroenterol. 2016 Mar;111(3):411-9.
http://www.ncbi.nlm.nih.gov/pubmed/26856753?tool=bestpractice.com
[214]Veauthier B, Hornecker JR. Crohn's disease: diagnosis and management. Am Fam Physician. 2018 Dec 1;98(11):661-9.
https://www.aafp.org/pubs/afp/issues/2018/1201/p661.html
http://www.ncbi.nlm.nih.gov/pubmed/30485038?tool=bestpractice.com
[215]To N, Gracie DJ, Ford AC. Systematic review with meta-analysis: the adverse effects of tobacco smoking on the natural history of Crohn's disease. Aliment Pharmacol Ther. 2016 Mar;43(5):549-61.
https://eprints.whiterose.ac.uk/97320
http://www.ncbi.nlm.nih.gov/pubmed/26749371?tool=bestpractice.com
Consulte Abandono do hábito de fumar.
Embora não haja consenso sobre as diretrizes para rastreamento de câncer colorretal em pacientes com DC, é amplamente aceito realizar colonoscopia de vigilância a cada 1-2 anos, começando 8 anos depois do estabelecimento do diagnóstico de pancolite e após 15 anos, no caso de colite no lado esquerdo.[306]Farraye FA, Odze RD, Eaden J, et al. AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology. 2010 Feb;138(2):738-45.
http://www.gastrojournal.org/article/S0016-5085(09)02202-1/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/20141808?tool=bestpractice.com
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How does surveillance compare with no surveillance for detecting colon cancer in people with ulcerative colitis or inflammatory bowel disease?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.1965/fullMostre-me a resposta A European Crohn's and Colitis Organisation recomenda que todos os pacientes com doença inflamatória intestinal (DII) sejam submetidos à colonoscopia de rastreamento 8 anos após a percepção dos sintomas iniciais, a fim de compreender, avaliar a extensão da doença e descartar a displasia.[289]Gordon H, Biancone L, Fiorino G, et al. ECCO guidelines on inflammatory bowel disease and malignancies. J Crohns Colitis. 2023 Jun 16;17(6):827-54.
https://academic.oup.com/ecco-jcc/article/17/6/827/6931718
Recomenda-se um exame perianal e anal completo durante cada colonoscopia.[305]Caldera F, Kane S, Long M, et al. AGA Clinical practice update on noncolorectal cancer screening and vaccinations in patients with inflammatory bowel disease: expert review. Clin Gastroenterol Hepatol. 2025 Apr;23(5):695-706.
https://www.cghjournal.org/article/S1542-3565(25)00020-5/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/39800200?tool=bestpractice.com
Recomenda-se a realização de rastreamento anual para detectar ansiedade e depressão em todos os adultos com DII.[304]Farraye FA, Melmed GY, Lichtenstein GR, et al. ACG clinical guideline update: preventive care in inflammatory bowel disease. Am J Gastroenterol. 2025 Jul 2;120(7):1447-73.
https://journals.lww.com/ajg/fulltext/2025/07000/acg_clinical_guideline_update__preventive_care_in.15.aspx
http://www.ncbi.nlm.nih.gov/pubmed/40701559?tool=bestpractice.com
[305]Caldera F, Kane S, Long M, et al. AGA Clinical practice update on noncolorectal cancer screening and vaccinations in patients with inflammatory bowel disease: expert review. Clin Gastroenterol Hepatol. 2025 Apr;23(5):695-706.
https://www.cghjournal.org/article/S1542-3565(25)00020-5/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/39800200?tool=bestpractice.com
Recomenda-se o rastreamento regular da displasia cervical para todas as mulheres adultas com DII.[305]Caldera F, Kane S, Long M, et al. AGA Clinical practice update on noncolorectal cancer screening and vaccinations in patients with inflammatory bowel disease: expert review. Clin Gastroenterol Hepatol. 2025 Apr;23(5):695-706.
https://www.cghjournal.org/article/S1542-3565(25)00020-5/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/39800200?tool=bestpractice.com
Em pacientes com DII, deve-se considerar a vacinação preventiva de rotina adequada à idade, especialmente se houver planos para terapia imunossupressora no futuro. As vacinas de agente vivo devem geralmente ser evitadas naqueles que administram imunossupressores. As vacinas de agente inativado são consideradas seguras e sua administração não está associada À exacerbação da DII. Consulte as diretrizes locais para obter informações atualizadas sobre as vacinas recomendadas.[304]Farraye FA, Melmed GY, Lichtenstein GR, et al. ACG clinical guideline update: preventive care in inflammatory bowel disease. Am J Gastroenterol. 2025 Jul 2;120(7):1447-73.
https://journals.lww.com/ajg/fulltext/2025/07000/acg_clinical_guideline_update__preventive_care_in.15.aspx
http://www.ncbi.nlm.nih.gov/pubmed/40701559?tool=bestpractice.com
[305]Caldera F, Kane S, Long M, et al. AGA Clinical practice update on noncolorectal cancer screening and vaccinations in patients with inflammatory bowel disease: expert review. Clin Gastroenterol Hepatol. 2025 Apr;23(5):695-706.
https://www.cghjournal.org/article/S1542-3565(25)00020-5/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/39800200?tool=bestpractice.com
NHS: Crohn's disease
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