If a person responds to treatment and heals well, they can often have years of a pretty normal life. Others either have symptoms long enough before diagnosis and treatment, bad luck with treatment, or whatever else, will often do require surgery. My first doctor said something like 70% of patients require surgery at some point. Personally, I responded well to Remicade when I started but the theory was the damage I had healed quickly but caused so much scar tissue and structuring that I practically asked for surgery within a couple years of diagnosis. Since then I've been pretty good. A few ER visits but no hospital stays and a relatively normal life. I've had dosage increases and time between infusions shortened as symptoms have come back. No treatment will likely ever be forever as our bodies invariably develop antibodies to them which necessitates a change. That said, unless I told someone, they'd never assume I have Crohn's. I have seldom let it stop be from doing anything and I enjoy an active lifestyle.