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Related Experiment Videos

Perianal Crohn's Disease.

Abhijit Basu1, Steven D. Wexner

  • 1Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Boulevard, Weston, FL 33331, USA. mcderme@ccf.org

Current Treatment Options in Gastroenterology
|May 11, 2002
PubMed
Summary

Perianal Crohn's disease management requires individualized treatment, as proximal disease activity doesn't always correlate with perianal symptoms. Symptomatic perianal Crohn's disease often needs specific therapies for optimal outcomes.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Perianal Crohn's disease frequently co-occurs with other Crohn's disease sites.
  • The link between proximal disease activity and perianal symptoms remains debated.

Purpose of the Study:

  • To clarify the management strategies for perianal Crohn's disease.
  • To emphasize the independent treatment needs of symptomatic perianal manifestations.

Main Methods:

  • Review of current treatment modalities for perianal Crohn's disease.
  • Discussion of medical and surgical interventions for specific perianal conditions like fissures, fistulae, and abscesses.
  • Evaluation of pharmacologic treatments including rectal mesalamine, antibiotics, immunosuppressants, and infliximab.

Main Results:

  • Hemorrhoids and anal fissures are primarily managed medically.
  • Fistulae and abscesses necessitate sepsis control, inflammation resolution, and preservation of continence.
  • Refractory fistulae may require surgical intervention or fecal diversion.
  • Infliximab shows promise in reducing surgical intervention needs.

Conclusions:

  • Symptomatic perianal Crohn's disease may require dedicated treatment irrespective of proximal disease activity.
  • A multimodal approach combining medical and surgical options is crucial for managing perianal Crohn's disease.
  • Optimizing perianal hygiene and skin protection aids in symptom management.

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