Paul Bostian is a 39-year-old high school guidance counselor who was diagnosed with an Ileal Crohn’s disease (an inflammatory bowel disease) when he was a teenager. For 20 years, he was treated medically with antidiarrheal agents and strong anti-inflammatory drugs. During that time, Paul had two spontaneous remissions. However, after these remissions, his disease always returned “with a vengeance.” Last year, he had a small bowel obstruction that could not be relieved with nonsurgical approaches, and underwent emergency surgery that removed 80% of his ilium. Subsequently, Paul has had diarrhea. His stools are oily, pale, and foul-smelling due to steatorrhea (fat in the stool).