Challenges in Crohn's Disease: Intestinal Failure and Short Bowel Syndrome in Crohn's Disease

Abstract Intestinal failure (IF) is a feared complication of Crohn's disease (CD), although data on the true incidence are sparse. Cumulative loss of small bowel due to bowel resections is often cited as the dominant mechanism, but studies from national IF referral units have identified postoperative abdominal sepsis as the most frequent event leading directly to IF. Reducing the requirement for intestinal surgery, improving the management of perioperative risk factors through structured optimisation, and judicious use of anastomoses are important strategies to reduce the risk of IF in people with CD.