Introduction

Crohn's disease and ulcerative colitis are the major forms of idiopathic inflammatory bowel disease. These conditions are chronic and relapsing in nature and primarily affect the small and large intestine, but occasionally the oral cavity, esophagus, and stomach can be involved. The precise etiology of these disorders is unknown, but they are generally felt to develop from a complex interplay of genetic, environmental, and microbial factors. There is generally no associated increase in mortality with inflammatory bowel disease, however there is often a high degree of morbidity, frequently requiring surgical intervention as part of the long-term treatment strategy. Although these diseases have many similarities, the indications for surgery and response to surgical therapy are quite different. In the majority of cases, clinical, radiological, and pathological findings will lead to the appropriate diagnosis; however in approximately 10% of cases, the distinction remains unclear and the patient is given a diagnosis of indeterminate colitis. It is imperative to have an accurate diagnosis prior to any planned surgical intervention in order to have the best possible outcome.

Crohn's disease

The incidence of Crohn's disease in the USA is estimated to be 5.8 cases per 100 000 person–years with a prevalence of 133 cases per 100 000 persons. It presents in a bimodal fashion with a peak in the second and third decades of life, and another in the sixth decade.