Postoperative Crohn’s prevention: Use structured, risk-based strategies; scope at 6 and 18 months; anti-TNF therapy is most effective for recurrence prevention.

Manage post-surgical issues: Treat bile acid malabsorption and SIBO empirically; check vitamin B12 at surgery and supplement if ileal resection >20 cm.

Vaccinate early: Begin herpes zoster, pneumococcal, and influenza vaccinations at IBD diagnosis—before immunosuppression.

Mitigate infection risks: Frailty doubles infection risk; monitor older and immunosuppressed patients closely and avoid thiopurines in EBV-naive patients.

Prioritize colonoscopy quality: Use team briefings, careful technique, and detailed documentation—there is no routine colonoscopy.