I've heard about surgery for Crohn's disease, but isn't that a losing battle? Won't the disease come back in a different location since it is a chronic disorder?

Ruth

Crohn's disease is a chronic inflammatory disease that typically affects the lower part of the small intestine (ileum) and/or the colon. Symptoms of this disease include diarrhea, abdominal pain, weight loss and fever. Although several types of medications are used to ease the inflammation associated with this disease, there is no cure for this chronic condition. Surgery is often required for Crohn's disease that is not controlled with maximum doses of medications or that leads to complications. In the first case, when large doses of steroids fail to get the disease under control, surgery to remove a diseased segment of intestine may allow a reduction in these medications. Steroids can cause many long-term side effects, so limiting their use is always desirable. In regard to the second issue, complications of Crohn's include intestinal obstruction (resulting from the chronic inflammation and scarring) and fistulas (abnormal connections from one bowel loop to another or to another organ). There is also a higher risk of colon cancer in patients with Crohn's disease who have colonic involvement. In all of these complications, surgery is often required.

More than half of patients with Crohn's will require surgery at some time. However, it is true that Crohn's can and often does recur after surgery. It usually recurs close to the area where the surgery was done. The reason for this is not known. Although this is less than an ideal situation, one must realize that the benefits of having the surgical procedure usually outweigh the effects of recurrence.

That said, surgery for Crohn's should be performed only when absolutely necessary. Usually this decision is made after careful discussions involving the patient, the gastroenterologist and the potential surgeon.