Crohn’s disease or Regional Enteritis is felt to be an autoimmune disease that can affect the entire G.I. tract anywhere from the mouth to the anus. The disease usually affects segments of the bowel with intermittent normal areas. Ulcerations and fistulas are common. Fistulas are holes that have eroded from the involved segment causing infections going to outside the skin or into other organs. Strictures are also fairly common in diseased areas. Symptoms usually include abdominal pain, diarrhea and rectal bleeding. Anal infections are common.
Crohn’s disease is similar to ulcerative colitis, in that it is more common in Western society, people of Northern European or Jewish heritage and has a genetic predisposition. In contrast to ulcerative colitis, surgery is generally not curative in Crohn’s disease; and is therefore, only indicated for complications of the disease. Nonetheless, greater than 50% of patients with Crohn’s disease will require surgery in the first decade of the diagnosis with a 70%-90% lifetime risk of surgery. The distribution of Crohn’s disease is: 40%-50% both large and small intestine affected, 30% small intestine alone, 20% colon alone, and 15%-40% perianal involvement with 3%-5% perianal disease alone. The most common area of involvement is the end portion of the small intestine or the terminal ileum.
Usually the first line of therapy for Crohn’s disease is medical therapy similar to ulcerative colitis. Remicaide or Humera, a relatively new group of medications, have been shown to be very effective with promising results. Crohn’s disease therapy requires a combined approach between the gastroenterologist and colorectal surgeon. We work in concert with nearly every gastroenterology group in the city to achieve the most optimum results for the patient. Therapy for Crohn’s disease requires a high degree of expertise in both medical and surgical fields.
For more information please visit:
The American Board of Colon and Rectal Surgeons