Crohn’s Disease is an inflammatory disease of the intestinal tract. The cause of Crohn’s Disease is not yet known although scientists and researchers believe that it is probably related to an immune phenomenon. Unlike Ulcerative Colitis which only involves the mucous membrane lining of the large intestine, Crohn’s Disease can involve all the layers of the intestinal tract any place between the mouth and the anus.
Crohn’s Disease usually occurs in one of four anatomic patterns. The Ileocolic pattern affects approximately 50% of patients with Crohn’s Disease. This pattern involves disease in the last few inches of the small intestine and the cecum, the first part of the large intestine. Approximately 25% of patients with Crohn’s Disease have involvement of only the small intestine. An equal number of patients have disease that affects only the large intestine. A very small group of patients (1-3%) present with Crohn’s Disease that only involves the anal canal.
Symptoms of Crohn’s disease include abdominal pain, nausea, vomiting, diarrhea with or without blood, fever, and weight loss. Patients with anal Crohn’s usually present with complicated fistulas, fissures and hemorrhoids.
The initial treatment of Crohn’s Disease is always with medicines and diet. Complications of Crohn’s Disease include intestinal obstruction, internal and external fistulas, abscess formation and failure to respond properly to medicines (intractability). When these complications occur surgery can sometimes be very helpful. Over the years many new procedures have been developed that preserve the intestine and the sphincter, thereby avoiding the need for colostomy or ileostomy. The Cleveland Clinic is one of the foremost institutions for treating Crohn’s Disease in the world. During his Fellowship training in Colon and Rectal Surgery at the Cleveland Clinic, Dr. Worsey had an extensive experience in the surgical management of Crohn’s Disease under the guidance of Dr. Victor W. Fazio and Dr. Ian C. Lavery.
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