Does Crohn's always require surgery? Can it just be okay or always severe and remission?

I have had Crohns for over 33 years. I have had many more good years than bad. Most of the folks here are usually sicker than most. The rest who are feeling well are just out there living their lives. Hope that helps.

Hi Brinycbri,

You ask a good question.  Everybody is different, and there are no absolutes.  For the most part, I generally have NO outward symptoms of Crohn's---hardly ever have diarrhea (usually have constipation, instead); and only have occasional cramping which may occur when I eat something with a lot of fiber.  When I go to the gastro and he presses on my lower abdominal area, I feel some tenderness---but on a daily basis it's generally not something I notice.

As for surgery, I've been fortunate so far to not need it.  The stats say that there is a high percentage that a person with Crohn's will need a surgery or two SOMETIME in their life.  But once again, there are no absolutes.

It also seems (& even according to research) that there may be several different TYPES of Crohn's; some of which may be more aggressive and symptomatic than others.

Even though I don't generally have OUTWARD symptoms, I do have the characteristic inward signs of Crohn's---Stricturing (narrowing) and inflammation (and probably some ulcerations) of the terminal ileum.  Just keep in mind that it's not the outward symptoms that do the damage; it's what's going on internally.  Therefore, I still need to be on medications to hopefully shove this into remission to delay the progression of the disease, at least temporarily. 

So PLEASE don't lose hope, and understand that everyone is different.  Typically when you read information on the Internet about Crohn's, it discusses the "typical" and sometimes worst case scenarios.  The articles simply generalize.

I wish you the best of luck, and hope that you're one of the fortunate ones to be in the category of a less aggressive type.

Yup, I concur, I have rarely been here over the past couple of years - managed it fine with diet alone.

When I was diagnosed I had a complete blockage. My doctor started remicade, prednisone,pentasa and antibiotics. He told me I may need surgery and then ended up I didn't. A couple months later I developed an infection and fistula. Doc put me on TPN for a month and talked about surgery again. I ended up not needing it again. A whole year has gone by, with some ups and downs and I think I'm doing pretty good! But I think if anything happens, I'm ready for it--this has made me a very strong person. And I have learned that every case is definitely different.

I have mild Crohn's. It was so mild that doctors said it was just IBS. Turns out that after 20+ years of this disease it did massive damage to my lower colon. I did have to have the last half of my colon removed but only because I wasn't being treated for Crohn's. As long as you stay on top of it and treat each emergency as it comes up, you might be able to avoid surgery.

Whatever you do, at the very least stay on a maintenance drug...like Blossom said, to help delay the progression of the disease - because as of today it is not a curable disease.

My GI has told me he has patients he diagnosed with Crohn's and has NEVER had to see them again because they've never had any more problems. He has other patients who have severe Crohn's and have had multiple surgeries. I fit somewhere inbetween, so the severity of your disease does make a difference in whether surgery is on the horizon for you.

The BEST thing is to be smart by taking the recommended medication prescribed to you; lead a clean/healthy lifestyle and be positive in your thoughts. All of that can go a long way in keeping you feeling good.

I'm like Curly, I've been in remission for 5 years with maintenance meds with only a brief blip after the birth of my daughter. When I was diagnosed I was told surgery was inevitable because I have a sever stricture. I'm planning on proving that prediction wrong. So far so good.