AIM: Surgery for Crohn's disease (CD) is characterized by an enhanced inflammatory response. While inflammation can induce hyperalgesia, post-operative pain following surgery for CD has not been characterized. This retrospective study compared a consecutive series of patients undergoing laparoscopic right hemicolectomy for CD and neoplasia performed by a single surgeon. METHOD: Elective resections performed between Jan-2016 and Aug-2017 managed in an enhanced recovery pathway were eligible for inclusion. Patients were excluded if open surgery was performed, an ileostomy was fashioned, no patient-controlled analgesia (PCA) was used or data were incomplete. Results : 38 cases were included, 20 for neoplasia and 18 for ileocolonic CD. There was no difference in patient gender (P=0.520). CD patients were younger (39.8+/-2.8 Vs 77.2+/-2.1 years, P<0.001) but had an equivalent length of resection (312.9+/-43.5 Vs 283.3+/-71.7 mm, P=0.915). CD patients had higher pain scores on post-operative day 1 (6.8+/-0.8 Vs 2.6+/-1.0, P<0.001), day 2 (5.0+/-0.5 Vs 1.6+/-0.9, P<0.001) and day 3 (4.1+/-0.6 Vs 1.3+/-0.7, P=0.008). CD patients used their PCA for longer (85.7+/-16.3 Vs 47.7+/-4.2 hours, P=0.017) and used a greater total amount of morphine (148.6+/-33.8 Vs 37.0+/-7.8 mg, P<0.001). Post-operative CRP was higher in patients with CD on day 1 (P=0.011), day 2 (P=0.001), day 3 (P=0.001) and day 4 (P=0.007), but no leak or intra-abdominal abscess occurred in either group. RESULTS: 38 cases were included, 20 for neoplasia and 18 for ileocolonic CD. There was no difference in patient gender (P=0.520). CD patients were younger (39.8+/-2.8 Vs 77.2+/-2.1 years, P<0.001) but had an equivalent length of resection (312.9+/-43.5 Vs 283.3+/-71.7 mm, P=0.915). CD patients had higher pain scores on post-operative day 1 (6.8+/-0.8 Vs 2.6+/-1.0, P<0.001), day 2 (5.0+/-0.5 Vs 1.6+/-0.9, P<0.001) and day 3 (4.1+/-0.6 Vs 1.3+/-0.7, P=0.008). CD patients used their PCA for longer (85.7+/-16.3 Vs 47.7+/-4.2 hours, P=0.017) and used a greater total amount of morphine (148.6+/-33.8 Vs 37.0+/-7.8 mg, P<0.001). Post-operative CRP was higher in patients with CD on day 1 (P=0.011), day 2 (P=0.001), day 3 (P=0.001) and day 4 (P=0.007), but no leak or intra-abdominal abscess occurred in either group. CONCLUSIONS: CD patients experience increased post-operative pain, require more post-operative analgesia and have an enhanced post-operative inflammatory response. Further studies to elucidate the mechanism of this hyperalgesia and strategies to obviate it are required.