Guide to Crohn's Disease

Reviewed by the physicians of Columbia’s Colorectal Surgery Team, March 2024

A stricture, or narrowing in a segment of the intestine. The illustrations above show the surgical approach to treat a stricture. We are experienced in performing this procedure using a minimally invasive approach.

Crohn's disease, also termed ileitis, regional enteritis, or granulomatous colitis, is a chronic inflammation of the intestine that extends into the deeper layers of the intestinal wall. Inflammation most often occurs in the lower section of the small intestine called the ileum and the first portion of the large intestine, the cecum (sometimes together called the ileocecal region). Crohn's disease can, however, develop in any part of the gastrointestinal tract, including the anus, stomach, esophagus, and even the mouth. It may affect the entire colon, develop as a string of contiguous ulcers in one part of the colon, or develop as multiple scattered clusters of ulcers with healthy tissue in between.

Crohn's disease is relatively rare and can often be controlled with medical management. Around 70% of Crohn's sufferers will require surgery at some point, typically to correct obstruction, abscesses, or perforation. While surgical treatment can alleviate the symptoms, it does not cure Crohn's disease.

If you or a loved one has received a diagnosis of Crohn's disease and would like a second opinion to confirm this diagnosis or discuss treatment options, please contact our Inflammatory Bowel Disease Center.

Note: Inflammatory bowel disease is a general term used to describe two chronic disorders of the gastrointestinal tract for which no specific cause has been found — ulcerative colitis and Crohn's disease.

Surgical Treatment for Crohn’s Disease

Surgeons in the Division of Colorectal Surgery have wide expertise in the comprehensive management of patients with Crohn's disease who require surgery. We perform a variety of abdominal operations on the duodenum, small bowel, colon and rectum, as well as perineal operations for anoperineal involvement. Whenever possible, we use minimally invasive procedures including laparoscopic surgery and operative techniques that preserve intestinal length and continence.

The decision whether to pursue medical or surgical treatment for Crohn's disease can be difficult. Close coordination between surgeons and experts including gastroenterologists, pathologists, nutrition, and radiologists facilitates decision-making and optimizes immediate and long-term management of our patients.

Our division has extensive experience with bowel resection, stricturoplasty, treatment of enterocutaneous fistulae and other intestinal fistulae and the use of reconstructive procedures when Crohn's disease involves the small intestine. For Crohn's disease involving the large intestine, our team has special expertise in the understanding of Crohn's colitis and continence preservation techniques, which allows for the control of disease and prevention of complications while maintaining quality of life. Our surgeons are frequently able to maintain intestinal continuity without a permanent ostomy even in complex circumstances.

For anorectal Crohn's disease, our expertise in surgical techniques facilitates prompt and effective treatment of various conditions such as abscesses, fissure, incontinence, and simple and complex fistulae while preserving continence.

Next Steps

If you or someone you love is in need of care for an IBD-related issue, we’re here to help. Our team is available for consultations, second opinions, and to perform any colorectal procedure, should one be necessary. Call us at (212) 305-9664 or request an appointment online.