Crohn’s disease is a chronic immune-mediated inflammatory condition that usually produces cumulative transmural intestinal damage. Disease-related complications, such as intestinal strictures and intra-abdominal penetrating complications (including enteric fistulae, inflammatory masses and abscesses), are mostly managed via a surgical approach, with ileocecal resection plus ileocolic anastomosis being the most common procedure. Despite the curative intention of surgery, however, up to 70% of patients develop new mucosal lesions in the neoterminal ileum within the first year of intestinal resection if no preventive therapy is started early after surgery. This postoperative recurrence (POR) can be described as endoscopic, clinical or surgical. Endoscopic POR—defined as the presence of mucosal lesions in the neoterminal ileum, as assessed by ileocolonoscopy—precedes the development of symptoms (clinical POR), which may lead to the need for new surgical resections (surgical POR). Here we discuss the errors to avoid when managing patients with Crohn’s disease in the postoperative setting. The discussion is based on evidence, whenever possible, as well as on our clinical experience and perception of the field.

Inflammatory bowel disease (IBD) is a chronic relapsing gastrointestinal disease, often affecting young people during their fertile years. The chronic character of IBD means that lifelong medical treatment is often required. As such, it is not surprising that questions often arise about fertility and pregnancy in patients with IBD. The most important risk factor for adverse pregnancy outcomes in IBD patients is the presence of disease activity during pregnancy. Indeed, negative pregnancy outcomes (e.g. spontaneous abortion, preterm delivery and low birth weight) are associated with disease activity at the time of conception and during pregnancy.