What is Crohn's Disease?

Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract from mouth to anus, most commonly the terminal ileum and colon. It causes transmural (full-thickness) inflammation leading to strictures, fistulas, abscesses and malnutrition. Unlike ulcerative colitis, Crohn's disease is not curable by surgery.

Medical Management

• 5-ASA compounds — mesalazine for mild colonic Crohn's
• Steroids — prednisolone/budesonide for inducing remission; not for maintenance
• Immunomodulators — azathioprine, 6-MP for maintenance of remission
• Biologics (Anti-TNF) — infliximab, adalimumab for moderate-severe disease and fistulising Crohn's
• Vedolizumab, Ustekinumab — second-line biologics for refractory disease
• Nutritional therapy — exclusive enteral nutrition for paediatric Crohn's

Surgical Management

Surgery is eventually needed in 70–80% of Crohn's patients. Dr. Ashok Kumar adopts a bowel-conserving approach — preferring stricturoplasty over resection where possible to minimise risk of short bowel syndrome. See the Crohn's Disease Surgery page for detailed surgical options.