OBJECTIVES This study aimed to understand patterns of treatment in patients with CD, including the initiation of treatment and changes of regimens over time. METHODS Cross-sectional data were collected via the Inflammatory Bowel Disease (IBD) Study Project during Q3 2008. Study participants were recruited from an Internet panel, and were reported to have physician-diagnosed IBD. Survey respondents were aged ≥18 years. RESULTS A total of 500 patients with CD completed the survey. Nearly half (43.5%) reported being diagnosed within a year of experiencing symptoms, and another 20.4% were diagnosed within 1-2 years. Most patients presented with moderate (36.2%) or severe (45.6%) disease at diagnosis. More than half (56.8%) began drug treatment within a month of diagnosis. When evaluating treatment patterns, 79.6% of patients used more than one treatment, and most changed to their second treatment within one year. Steroids (52.0%) and 5-aminosalisylic acids (54.0%) are the most common initial treatment options. Immunomodulators and biologics are not used often as first line therapy, but their use increases with the number of treatments. More than half of patients (53.0%) had the dose of their initial treatment increased, but increasing dose becomes a less common strategy for future treatments. Paradoxically, as the number of treatments increase, the number of patients experiencing surgery and reporting severe disease decreases. CONCLUSIONS The majority of CD patients are diagnosed and treated within a year of experiencing symptoms. Multiple treatments are common, with self-reported disease severity decreasing with an increase in the number of treatments, especially when immunomodulators and biologics have been utilized. Research identifying the most effective treatments that control disease and decrease surgery, and the optimal time when they should be used during the natural course of the disease, is needed.