The problem of postoperative recurrence of Crohn's disease

Most patients with Crohn's disease require an operation and the overwhelming majority will ultimately experience a recurrence of the disease at the anastomosis. Clinical manifestation of postoperative recurrence appear at a cumulative rate of nearly 10 per cent per year. New evidence suggests that Crohn's disease may follow at least two different patterns, 'aggressive' fistulizing disease with early surgery and rapid recurrence, or 'indolent' stricturing disease with relatively later surgery and slower obstructive recurrence. Pathophysiologic and clinical studies should take into account this duality of clinical patterns.