By Dr Pranab Gyawali, Consultant Gastroenterologist (UK-trained) in Dubai
In this video, I talk through one of the most important decisions in Crohn’s disease, particularly when it affects the terminal ileum, which is the most common pattern at diagnosis.
I explain how we think about the choice between surgery and infliximab, and why this conversation needs to happen earlier than many patients expect.
What is this research and why does it matter?
This discussion is based on long-term data comparing surgery and infliximab for Crohn’s in this exact area.
If you want to explore the research in more detail, you can view it here:
View the study
What decision are we actually making?
For Crohn’s affecting the terminal ileum, the decision is between biologic therapy such as infliximab or surgery to remove the affected segment.
The way I think about this in clinic
The mistake I often see is that surgery is not discussed early enough. For localised disease, it should be part of the early conversation.
When do I consider surgery?
- Localised disease in the terminal ileum
- Short segment involvement
- No complex complications
- Standard treatments not working well
Where does infliximab fit?
Infliximab remains an important treatment, particularly when disease is more widespread or complex.
Recommended Guides
- Crohn’s Disease Specialist Dubai
- Learn about Biologicals used in UC and Crohn’s in Dubai
- Gastroenterology Services Dubai
- Gut Microbiome in Crohn’s
Crohn’s Treatment VLOGs
Diet, Microbiome and Crohn’s
Related Gastroenterology Topics
Investigations and Procedures
If you wish to discuss this further or would like to make an appointment, please use the booking form on this page.