Granulomatous Bowel (Crohn's) Disease

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Abstract
Ninety-two patients had regional enteritis or granulomatous colitis, or both. The variable nature of this disease and the difficulty of evaluating therapy are illustrated by patient summaries. Site and extent of bowel involvement at the time of diagnosis did not influence prognosis. Mortality, operation rate, and number of complications were similar in steroid and non-steroid treated patients when they were matched retrospectively by age, sex, site, and extent of disease. An actuarial analysis of results of surgical therapy suggested a higher risk of recurrence and consequent further resection after each additional major operation. Presence of Crohn's disease indicated need for supportive medical care. If this fails steroid therapy should be given a trial. Surgical intervention should be reserved for patients with mandatory surgical indication and those with incapacitating symptoms which have failed to respond to medical therapy.