[a9h74j]

Since you specifically mention one cure through removal, my data point on Crohns and surgery: Took years for me to finally get a clue about surgery for Crohns in a case as unremittant as mine. My guess at the time was that MDs consider referral to surgery as "medical failure" -- I've seen that term in the literature -- so do not volunteer the option.

Anecdata: Root canal, antibiotics, and first Crohns indications in the span of 10 days for me.

[danachow]

> "medical failure"

Medical failure in the literature is a jargon term. (Internal) medicine and surgery are traditionally two distinct fields of, er, medicine. So it is just a matter of fact that a disease such as Crohn's that is refractory or resistant to treatment with medicine is a "medical failure" - no spin on it, that's what we call it.

Biases in referral across services is a complicated topic, and there is quite a bit of literature about it over the years. I am not sure about Crohn's/IBD specifically, but it's one of the well known co-management touch-points between surgery and GI, so there might be something written on the subject. There are many complexities at play here, some is definitely due to human factors, but the simple thought of "medical failure" doesn't have much to do with it. The average internists make thousands of consults to surgery every year, so that's really not it, there's much more to it.

[a9h74j]

Thanks, very helpful. That is one less questionable inference I will carry around.

Speaking of complexities, I'm fairly sure the GI who did not refer me was married -- so he told me I'm 98% sure -- to a pharmaceutical salesperson who sold GI related infusions (and he got me in a perhaps unrelated study). There were other manner-related problems. .. Does not change my profound regard for MDs in general. (Have worked with MD/PhDs, wouldn't be alive without some interventions, very dedicated care, etc.) Be well.