I am sorry to hear about your concerns. Crohn s disease is a result from activation of inflammatory cells, whose by-products produce nonspecific tissue injury specifically in the walls of the intestinal tract, as well as many other organs throughout your body. The hallmark features of inflammation results in fibrosis, stricture formation, and fissures leading to sinus tracts, abscesses, or fistulas. In addition, most people have ulcerations and perianal disease such as pain, anal fissures, and perirectal abscesses. Genetic, environmental triggers, and immunologic abnormalities result in inflammation and tissue injury in genetically predisposed individuals. I would recommend: -due to the complex and detrimental effects of Crohn s disease, I would highly recommend continuing Pentasa. However, I would speak to your prescribing doctor about your concerns. Asymptomic patients with mild disease can sometimes do well without medication. Stopping Pentasa puts you at risk for having a flare and complications which can be detrimental at your age. -smoking cessation: tobacco cessation may reduce frequency of flares and relapses -Food high in refined sugars and animal fats may have a role in triggering Crohn s. -Infections, NSAIDs (tylenol, ibuprofen), and stress can exacerbate flares -Update vaccinations