Prehabilitation prior to intestinal resection in Crohn’s disease patients: An opinion review

Table 1 Recommendations on screening for prehabilitation prior to intestinal surgery in Crohn’s disease

Screening
Nutritional status	Screening in all patients: Body mass index, evaluation of unintentional weight loss and assessment of dietary intake with nutritional or immunological screening tools (e.g., GLIM and OPNI). Preferably assess the muscle mass (e.g., with handgrip strength or consider available imaging techniques) to complement the measures of nutritional status
Physical fitness	Screening in all patients to estimate aerobic fitness with validated self-reporting questionnaire (e.g., Duke activity status index, veterans-specific activity questionnaire). Consider referral of patients at risk for impaired physical fitness for comprehensive objective assessment by an exercise specialist
CD medication	Critically revise all current CD medication on a case-by-case basis
Laboratory assessment	Preoperative assessment of full blood count, CRP, and serum albumin. Assessment of vitamins and other trace elements may only be indicative in patients with biochemical remission
Smoking psychological status	Screen all patients on active smoking
	Discussion of expectations and potential fears for the perioperative course by treating physicians IBD team members

CD: Crohn’s disease; CRP: C-reactive protein; GLIM: Global Leadership Initiative on Malnutrition; IBD: Inflammatory bowel disease; OPNI: Onodera’s prognostic nutritional index.