Should We Divide Crohn's Disease Into Ileum-dominant and Isolated Colonic Disease?


Crohn's disease (CD) is an inflammatory bowel disease, which can involve any region of the gastrointestinal tract. First described in 1932 as terminal ileitis or regional enteritis, it predominately involves the ileum with or without colonic involvement. Isolated colonic CD was first described in 1960 and since then the phenotypic classification of CD has evolved to stratify patients into isolated ileal, ileocolonic, or isolated colonic involvement. In the current review we evaluate the published literature regarding differences in epidemiology, natural history, pathogenesis, response to therapy, and disease monitoring, when stratified by disease location. Based on the available evidence consideration could be given to a new classification for CD, which splits it into ileum dominant (isolated ileal and ileocolonic) and isolated colonic disease. This may allow for a more optimized approach to clinical care and scientific research for CD.


Dulai PS1, Singh S2, Casteele NV2, Boland BS2, Rivera-Nieves J2, Ernst PB2, Eckmann L2, Barrett KE2, Chang JT2, Sandborn WJ2. Clin Gastroenterol Hepatol. 2019 Apr 19. pii: S1542-3565(19)30430-6. doi: 10.1016/j.cgh.2019.04.040. [Epub ahead of print]

Author Information

1.  University of California San Diego, La Jolla CA. Electronic address: pdulai@ucsd.edu.

2.  University of California San Diego, La Jolla CA.