Guía informada por la evidencia para el manejo de la enfermedad de Crohn en población adulta: recomendaciones de la Pan American Crohn's and Colitis Organisation (PANCCO)

Fabian Juliao-Baños; Viviana Parra-Izquierdo; Gabriela Abreu; Jordi Alonso Soto; David Andrade Zamora; Oscar Giovanni Avelar Escobar; Carla Bianchi; Hugo Cedron Cheng; Víctor Hugo Fúnez Madrid; Fabio Leonel Gil Parada; Camilo Guillermo Guerrero Velasquez; Paulo G Kotze; Verónica Lockward Grullón; Francisca Martínez Silva; Daniela Méndez Loayza; Juan Paredes Méndez; Carlos Paredes; Ligia Yukie Sassaki; Priscila Saborío-Montero; Rolando Sepúlveda Cortés; Astrid Rausch; Carlos Rettally; Maisa Vallejos; Jairo Amaya-Guío; Rodrigo Pardo Turriago; Yessica León Avendaño; Jesús K Yamamoto-Furusho; Kenneth Ernest-Suarez

doi:10.47892/rgp.2026.463.2299

Autores/as

Fabian Juliao-Baños Hospital Pablo Tobón Uribe, Medellín, Colombia. https://orcid.org/0000-0002-8610-9925
Viviana Parra-Izquierdo Hospital Internacional de Colombia, Santander, Colombia; Grupo de Inmunología Celular y Molecular (InmuBo), Universidad El Bosque, Colombia. https://orcid.org/0000-0003-2361-1018
Gabriela Abreu Universidad Central de Venezuela, Caracas, Venezuela. https://orcid.org/0009-0009-7428-9330
Jordi Alonso Soto Hospital Clínico Quirúrgico Hermanos Ameijeiras, La Habana, Cuba. https://orcid.org/0000-0002-8396-2752
David Andrade Zamora Hospital José Carrasco Arteaga, Instituto Ecuatoriano de Seguridad Social, Cuenca, Ecuador. https://orcid.org/0009-0007-8860-2119
Oscar Giovanni Avelar Escobar Servicio de Gastroenterología Clínica de Intestino, Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador. https://orcid.org/0000-0002-8077-8618
Carla Bianchi Asociación Española de Montevideo, Uruguay; Sanatorio Cantegril, Punta del Este, Uruguay; Sanatorio Mautone, Punta del Este, Uruguay. https://orcid.org/0009-0008-2608-2258
Hugo Cedron Cheng Clínica Anglo Americana, Lima, Perú. https://orcid.org/0000-0002-9057-829X
Víctor Hugo Fúnez Madrid Torre Xcala, Tegucigalpa, Honduras. https://orcid.org/0009-0008-0291-5892
Fabio Leonel Gil Parada Clínica Universitaria Colombia, Bogotá, Colombia. https://orcid.org/0000-0002-4008-6123
Camilo Guillermo Guerrero Velasquez Gastro Clinic, Managua, Nicaragua. https://orcid.org/0000-0003-3303-5317
Paulo G Kotze Health Sciences Postgraduate Program Pontificia Universidade Catolica do Parana (PUCPR), Curitiba, Brazil. https://orcid.org/0000-0002-9632-6691
Verónica Lockward Grullón Clínica Universitaria Unión Médica, Centro de Excelencia EII, Santiago de los Caballeros, República Dominicana.
Francisca Martínez Silva Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, Ciudad de México, México. https://orcid.org/0000-0002-9243-6906
Daniela Méndez Loayza ENDOCENTER, La Paz, Bolivia; Servicio de Gastroenterología, Hospital Arcoíris, La Paz, Bolivia. https://orcid.org/0000-0002-2454-2969
Juan Paredes Méndez Hospital Guillermo Almenara Irigoyen, Lima, Perú. https://orcid.org/0000-0001-5748-3312
Carlos Paredes Hospital General de Enfermedades, IGSS, Ciudad de Guatemala, Guatemala. https://orcid.org/0000-0001-9868-1577
Ligia Yukie Sassaki Department of Internal Medicine, Medical School, São Paulo State University (Unesp), São Paulo, Brazil. https://orcid.org/0000-0002-7319-8906
Priscila Saborío-Montero Universidad de Costa Rica, San José, Costa Rica; Hospital Dr. Enrique Baltodano, Liberia, Costa Rica. https://orcid.org/0009-0002-4334-1174
Rolando Sepúlveda Cortés Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile; Unidad de Gastroenterología, Hospital Dr. Hernán Henríquez Aravena, Temuco, Chile. https://orcid.org/0000-0002-8405-4035
Astrid Rausch Hospital Británico, Buenos Aires, Argentina. https://orcid.org/0000-0003-4969-7585
Carlos Rettally Unidad de investigación en enfermedades digestivas, Pacífica Salud, Gastroenterólogos Asociados, Ciudad de Panamá, Panamá. https://orcid.org/0000-0002-5025-6819
Maisa Vallejos Hospital de Clínicas, Universidad Nacional de Asunción, Asunción, Paraguay. https://orcid.org/0009-0001-5052-3542
Jairo Amaya-Guío Universidad Nacional de Colombia, Bogotá, Colombia. https://orcid.org/0000-0002-4227-585X
Rodrigo Pardo Turriago Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Bogotá, Colombia. https://orcid.org/0000-0001-7411-5853
Yessica León Avendaño Fundación Santa Fe de Bogotá, Bogotá, Colombia.
Jesús K Yamamoto-Furusho Departamento de Gastroenterología, Clínica de Enfermedad Inflamatoria Intestinal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México. https://orcid.org/0000-0002-5247-5812
Kenneth Ernest-Suarez Universidad de Costa Rica, San José, Costa Rica; División de Gastroenterología, Universidad de Alberta, Edmonton, Alberta, Canadá. https://orcid.org/0000-0001-8360-8190

DOI:

https://doi.org/10.47892/rgp.2026.463.2299

Palabras clave:

Enfermedad de Crohn, Guía de Práctica Clínica, América Latina, Terapia Biológica

Resumen

Introducción. La enfermedad de Crohn (EC) es una enfermedad inflamatoria intestinal crónica, recidivante y progresiva cuya incidencia y prevalencia han aumentado de forma sostenida en América Latina, asociadas a la urbanización y la occidentalización de los estilos de vida. Su curso heterogéneo, el daño estructural acumulativo y el impacto en la calidad de vida justifican recomendaciones regionales que orienten el tratamiento médico, endoscópico y quirúrgico de los adultos afectados. Objetivo. Presentar las recomendaciones informadas por la evidencia de la guía de la Pan American Crohn's and Colitis Organisation (PANCCO) para el manejo de la EC en adultos latinoamericanos. Metodología. La guía se desarrolló mediante adaptación y actualización de la guía de la Asociación Colombiana de Gastroenterología (2020), siguiendo las orientaciones de la OPS/OMS. Un grupo desarrollador interdisciplinario formuló siete preguntas clínicas en formato PICO; cuatro fueron actualizadas mediante búsquedas sistemáticas (enero 2020–febrero 2026) en MEDLINE, Embase, Cochrane y Epistemonikos, con evaluación de calidad mediante AMSTAR-2, ROBIS, RoB 2.0 y ROBINS-I, y calificación de la certeza y formulación de recomendaciones mediante el sistema GRADE. Resultados. Se formularon 52 recomendaciones organizadas en siete preguntas clínicas sobre predicción de recaída, inducción y mantenimiento de la remisión con terapia convencional, terapia avanzada en enfermedad moderada a grave, enfermedad perianal fistulizante, abordaje quirúrgico-endoscópico y prevención de la recurrencia posquirúrgica, complementadas con puntos de buena práctica clínica. Conclusiones. Esta guía reúne la evidencia más reciente disponible para el tratamiento de la EC en adultos, incorporando el uso de terapias avanzadas, el manejo multidisciplinario de la enfermedad perianal fistulizante, y el papel de la cirugía y la endoscopia terapéutica, ofreciendo un marco práctico para la toma de decisiones clínicas en el contexto de recursos y necesidades propio de América Latina.

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