ABSTRACT

Crohn 's disease is inherently refractory. The condition is medically incurable and recurs in a predictable pattern after surgical resection. Therefore, the concept of refractoriness must be considered in relative terms within the context of levels of treabnent. Furthermore, in the absence of curability or a gold standard against which to measure disease activity defining response to refractory disease is also relative, depending on the circumstances of the disease state.