How Is Each Type of Crohn's Disease Different?

There are 5 different types of Crohn’s disease, based on what areas of the gastrointestinal tract are affected. Each type of Crohn’s disease varies in symptoms, and the disease location greatly affects the treatment plan.

Apart from the 5 different types of Crohn’s disease, Crohn’s advances in three various ways (or phenotypes): inflammatory, stricturing, and penetrating. Due to the fact that a majority of individuals experience a mix of all of these three approaches, it can be difficult to identify the exact one type of Crohn’s disease because they can overlap. Throughout the years, researchers have also found that location of Crohn’s symptoms is not the only factor associated with the disease’s development. According to a recent study, age of diagnosis, extent of the disease, and the disease’s impact on the body are all drivers that determine development. For instance, the study found that being diagnosed at a younger age is typically associated with a more aggressive and widespread form of the disease in both Crohn’s disease and ulcerative colitis.

When is surgery really necessary for Crohn’s?

Depending on what part of the area is affected by Crohn’s disease, surgery may be recommended. The objective of surgery for Crohn’s is to remove the affected areas with a bowel resection. For patients who have already had a large amount of the small bowel removed, a technique called stricturoplasty may be recommended to help preserve intestinal length. “Yes, there are pros and cons as well as risks associated with any surgery. In most cases, however, patients with Crohn's disease come to surgery when they and their gastroenterologist have exhausted all of the medical options for treatment. Surgery will remove the segments of intestine affected with Crohn's disease and allow the patient to get off of medicines like prednisone. Obstructive symptoms are relieved, and the patient can anticipate a return to an excellent quality of life,” said Dr. Emre Gorgun, colorectal surgeon.

The risk of recurrence

Unfortunately, there is always the risk of Crohn's recurrence following surgery. However, a majority of patients go an average of 10 years in between surgeries. “When part of the small intestine and colon are removed and a reconnection is created, up to 80% of patients will develop recurrence of their Crohn's over the next 10 to 15 years. In some situations, physicians will recommend starting medication shortly after surgery as a preventative maneuver to reduce the risk of disease coming back. It is also important to note that smoking significantly increases the risk of Crohn's recurrence after surgery, so smokers can help themselves to a great extent by quitting,” said Dr. Jean-Paul Achkar, gastroenterologist.

Read on to learn about the 5 different types of Crohn's disease, how they are similar, and how they are different from one another.