Aims & Objectives: To study the usage of Steroids in Perioperative Inflammatory Bowel Disease.

Methodology: This is Prospective Observational study conducted in the Department of Surgery at RMMCH for the duration of 3months.

Results: In this study, 102 patients were enrolled in which majority of patients were female (66.4%) than male (33.6%). Among them, majority of patients fall under 30-40 years of age group, for about 50.9% and least among 20-30years of age group, for about 21.5%. Likewise, number of patients who have inflammatory bowel disease co-existed with diabetic mellitus were around 37.1%, anemia 26.4%, renal disease 24.7%, cardiac 11.5%. Among these patients, 73.3% female patients were reported with Crohn’s disease in which 54.5% took steroids and 26.6% were male patients reported with Crohn’s disease with 75% steroid usage.73.8% males were having Ulcerative colitis in which 44.4% patients took steroid drugs and 26.7% female’s patients were reported with Ulcerative colitis with 41.6% steroid usage.

Conclusion: Preoperative steroid use was 44.4% & 41.6% in case of male and female patients in ulcerative colitis whereas in Crohn’s disease steroid usage by male and female patients were 75% & 54.5%. In our study, male patients with Crohn’s disease found to have higher steroid usage (75%), therefore, the male patients with Crohn’s disease having higher risk of postoperative complications, so more number of studies are needed to rectify the effect of preoperative steroid usage.

Keywords: Steroids Usage, Inflammatory Bowel Disease, Crohn’s Disease, Ulcerative colitis.

1. Fasth S, Hellberg R, Hulten L, Magnusson O. Early complications after surgical treatment for Crohn's disease with particular reference to factors affecting their development. ActaChir Scand 1980;146:519–26.
2. Heimann TM, Greenstein AJ, Mechanic L, AufsesJr AH. Early complications following surgical treatment for Crohn's disease. Ann Surg 1985;201:494–8.
3. Post S, Betzler M, von Ditfurth B, Schurmann G, Kuppers P, Herfarth C. Risks of intestinal anastomoses in Crohn's disease. Ann Surg 1991;213:37–42.
4. Ziv Y, Church JM, Fazio VW, King TM, Lavery IC. Effect of systemic steroids on ileal pouch-anal anastomosis in patients with ulcerative colitis. Dis Colon Rectum 1996; 39:504–8.
5. Page MJ, Poritz LS, Kunselman SJ, Koltun WA. Factors affecting surgical risk in elderly patients with inflammatory bowel disease. J Gastrointest Surg 2002;6:606–13.
6. Mahadevan U, Loftus Jr EV, Tremaine WJ, Pemberton JH, Harmsen WS, Schleck CD, et al. Azathioprine or 6-mercaptopurine before colectomy for ulcerative colitis is not associated with increased postoperative complications. Inflamm Bowel Dis 2002;8:311–6.
7. Aberra FN, Lewis JD, Hass D, Rombeau JL, Osborne B, Lichtenstein GR. Corticosteroids and immunomodulators: postoperative infectious complication risk in inflammatory bowel disease patients. Gastroenterology 2003;125:320–7.
8. Tay GS, Binion DG, Eastwood D, Otterson MF. Multivariate analysis suggests improved perioperative outcome in Crohn's disease patients receiving immunomodulator therapy after segmental resection and/or strictureplasty. Surgery 2003;134: 565–72.
9. Bruewer M, Utech M, Rijcken EJ, Anthoni C, Laukoetter MG, Kersting S, et al. Preoperative steroid administration: effect on morbidity among patients undergoing intestinal bowel resection for Crohn's disease. World J Surg 2003;27:1306–10.
10. Subramanian V, Saxena S, Kang JY, Pollok RC. Preoperative steroid use and risk of postoperative complications in patients with inflammatory bowel disease undergoing abdominal surgery. Am J Gastroenterol 2008;103:2373–81.
11. Khuri SF, Henderson WG, Daley J, Jonasson O, Jones RS, Campbell Jr DA, et al. The patient safety in surgery study: background, study design, and patient populations. J Am CollSurg 2007;204: 1089–102.
12. Daley J, Khuri SF, Henderson W, Hur K, Gibbs JO, Barbour G, et al. Risk adjustment of the postoperative morbidity rate for the comparative assessment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study. J Am CollSurg 1997;185:328–40.
13. Khuri SF, Daley J, Henderson W, Hur K, Gibbs JO, Barbour G, et al. Risk adjustment of the postoperative mortality rate for the comparative assessment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study. J Am CollSurg 1997;185:315–27.
14. Daley J, Forbes MG, Young GJ, Charns MP, Gibbs JO, Hur K, et al. Validating risk-adjusted surgical outcomes: site visit assessment of process and structure. National VA Surgical Risk Study. J Am CollSurg 1997;185:341–51.
15. Khuri SF, Henderson WG, Daley J, Jonasson O, Jones RS, Campbell Jr DA, et al. Successful implementation of the Department of Veterans Affairs' National Surgical Quality Improvement Program in the private sector: the Patient Safety in Surgery study. Ann Surg 2008;248:329–36.
16. Lichtenstein GR, Feagan BG, Cohen RD, Salzberg BA, Diamond RH, Chen DM, et al. Serious infections andmortality in association with therapies for Crohn's disease: TREAT registry. Clin Gastroenterol Hepatol 2006;4:621–30.

Dr N.Junior Sundresh

Professor, Department of Surgery, R.M.M.C.H, Annamalai University

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