Inflammatory Bowel Disease: Diagnosis and Therapeutics

One of the most vivid memories from my medical school training was seeing my first surgical operation on a patient with Crohn’s disease. The senior surgeon at Mount Sinai Hospital in New York City, the same institution at which Burrill Crohn, Leon Ginzburg, and Gordon Oppenheimer had first described the disease “terminal ileitis,” had - doubtedly done countless operations on patients with inflammatory bowel disease in the past. Yet as we both gazed down into the patient’s open abdomen, at the “creeping fat” that seemed to be wrapping its sticky fingers around the young man’s intestines, he stated, “this is the m- tery of Crohn’s disease—no two patients are ever the same. ” What is it about the inflammatory bowel diseases, Crohn’s disease, and ulcerative colitis, that we find so intriguing? Is it the young age of the patients, many who are younger than even the medical students - tending to them? Or is it the elusive etiology, the theory of a “mystery organism” that has yet to be identified? Perhaps it is the familial pattern of disease, where many patients have relatives with similar diseases, yet in some instances only one of a pair of identical twins is affected. Regardless of the cause, these chronic diseases with a typically early age of onset, result in a long-term commitment of the patient, their fa- lies, friends, health care providers, researchers, employers, and even health care insurers and other health-related industries.