Surgery for adult Crohn's disease: what is the actual risk?

Introduction When Crohn and his colleagues first described regional ileitis in 1932, 1 intestinal resection was the only effective treatment available for these patients. [...]the introduction of steroids during the 1950s, medical treatments for Crohn's disease (CD) were limited to digestive rest or 'High vitamin, high protein, high carbohydrate, low residue diet with liver, iron and calcium supplements and the judicious use of sedatives and antispasmodics'. [...]the authors used an empirical definition of early CD. 39 A formal definition of early CD is eagerly awaited. 40 In the SONIC trial, the rates of surgery have not been published. 41 A disease modification trial comparing a top-down approach (anti-TNFα with concomitant immunosuppressant) with a step-up approach according to current recommendations 42 and enrolling several hundred patients with a well-defined definition of early CD and with long-term follow-up could address this issue further.