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

Parambir S. Dulai*, Siddharth Singh, Niels Vande Casteele, Brigid S. Boland, Jesus Rivera-Nieves, Peter B. Ernst, Lars Eckmann, Kim E. Barrett, John T. Chang, William J. Sandborn

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

36 Scopus citations


Crohn's disease (CD) is an inflammatory bowel disease that 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.

Original languageEnglish (US)
Pages (from-to)2634-2643
Number of pages10
JournalClinical Gastroenterology and Hepatology
Issue number13
StatePublished - Dec 2019
Externally publishedYes


  • Classification
  • Colonic
  • Crohn's Disease
  • Ileal

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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