i Crohnz

Coming Soon

A patient community and resource hub for Crohn's disease — surgery, biologics, fistula, stricture, and living well with IBD.

What is iCrohnz?

iCrohnz.org is being built by the Holubar Lab to give Crohn's disease patients and their families a trusted, surgeon-led resource.

Topics will include surgical options, biologic therapy, fistula and stricture management, nutrition, and quality of life after IBD surgery.

Ileocolic Resection Strictureplasty Biologics Fistula Perianal CD Nutrition

Questions? Contact us at [email protected]

Frequently Asked Questions

What is Crohn's disease?

Crohn's disease is a chronic inflammatory bowel disease (IBD) that can affect any segment of the digestive tract from mouth to anus, but most commonly involves the terminal ileum and colon. It causes transmural inflammation — affecting the full thickness of the bowel wall — leading to symptoms such as abdominal pain, diarrhea, weight loss, and fatigue. Unlike ulcerative colitis, Crohn's disease can affect skip areas (non-continuous segments) and is associated with complications including strictures, fistulas, and abscesses.

When is surgery needed for Crohn's disease?

Surgery is considered when medical therapy — including corticosteroids, immunomodulators, and biologic agents such as anti-TNF and JAK inhibitors — fails to control symptoms or when complications arise. Common surgical indications include intestinal obstruction from a stricture, internal or perianal fistula, abscess, perforation, dysplasia, or medically refractory disease. Approximately 70–80% of Crohn's patients require at least one surgical procedure during their lifetime.

What is an ileocolic resection?

Ileocolic resection is the most common surgical procedure for Crohn's disease, removing the diseased segment of terminal ileum and the right colon (cecum and ascending colon) along with the ileocecal valve. The two ends of healthy bowel are then joined (anastomosis). It is performed laparoscopically or robotically in most centers. Crohn's disease recurs after ileocolic resection in up to 50% of patients within five years, so postoperative biologic prophylaxis is standard of care.

What is a strictureplasty?

Strictureplasty is a bowel-sparing procedure that widens a narrowed (strictured) segment of small bowel without removing it, preserving intestinal length. This is especially important in patients with multiple prior resections at risk for short-bowel syndrome. The Heineke-Mikulicz technique is used for short strictures; the Finney or isoperistaltic techniques for longer ones. Strictureplasty is appropriate only for fibrotic (non-inflammatory) strictures without active sepsis or malignancy.

How do biologics and advanced therapies fit into Crohn's disease treatment?

Biologic agents — anti-TNF antibodies (infliximab, adalimumab, certolizumab pegol), anti-integrin agents (vedolizumab), and anti-IL-12/23 agents (ustekinumab, risankizumab) — are the cornerstone of moderate-to-severe Crohn's disease management. JAK inhibitors (upadacitinib) offer an oral alternative. The goal is mucosal healing, not just symptom control. Combination therapy with an immunomodulator reduces immunogenicity. Therapeutic drug monitoring guides dose optimization and switch decisions.

What is perianal Crohn's disease and how are fistulas treated?

Perianal Crohn's disease affects up to 40% of patients and encompasses skin tags, fissures, abscesses, and fistulas. Perianal fistulas are abnormal tracts between the rectum/anal canal and the perianal skin (or adjacent structures). Management combines surgical drainage (seton placement to control sepsis) with medical therapy (anti-TNF biologics, particularly infliximab). Definitive closure procedures — advancement flaps, LIFT procedure, or fistula plug — are considered once inflammation is controlled. Severe refractory perianal disease occasionally requires diversion or proctectomy.

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