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Crohn’s disease is a disease of chronic inflammation involving any part of the intestinal tract.
Crohn’s disease most commonly affects the last part of the small intestine (ileum) and/or the large intestine (colon and rectum). It is relatively uncommon in the Asian population.
Crohn’s disease is a chronic condition and may recur at various times over a lifetime. Some people have long periods with no disease, sometimes years, when they are free of symptoms. There is no way to predict when the disease can come back.
Initial treatment is with medication. The most common drugs used are steroids such as prednisolone, and various anti-inflammatory agents. The drugs do not “cure” Crohn’s disease (there is no “cure” available yet), but the drugs are used to relieve its symptoms and may help to avoid recurrence.
In more serious cases, stronger drugs such as 6-mercaptopurine and azathioprine may be used. However, these drugs have more side effects and suppress the immune system, making the patient more prone to infection.
In more advanced or complicated cases of Crohn’s disease, surgery may be recommended.
Emergency surgery is performed when complications, such as a perforation of the intestine, obstruction (blockage) of the bowel, or massive bleeding occur with Crohn’s disease. Operations may also be needed in patients who do not respond to medication, patients with abscess formation, fistulas (abnormal communication from the intestine), and patients with severe anal disease.
Although drug treatment is used initially, up to three-quarters of patients may eventually require surgery. Surgery is not “curative”, although many patients never require additional operations. A conservative approach is frequently taken at surgery, with only the diseased portion of the intestines being removed.
Surgery may provide long-term relief of symptoms and decreases the need for medications. Surgical therapy is best conducted by a surgeon skilled and experienced in the management of Crohn’s disease.
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