[Anal and perianal operations in ulcerative colitis and Crohn's disease]

Inflammation in ulcerative colitis is concentrated in the mucous membrane. Therefore, increased frequency of perianal and anal lesions is not to be expected and therapy does not differ from that in patients without inflammatory bowel disease. This study concentrates mainly on Crohn's disease and provides an overview on skin disorders, skin tag, fissure in ano, fistulae and abscess, stenosis, incontinence and the management of these conditions. A decision is necessary between four approaches to treatment: 1. Wait and see regarding the natural course. 2. Treatment of intestinal manifestations. 3. Conservative therapy concentrating on the anal lesion. 4. Local or extensive surgery. The indications for surgery should not be aggressive (except for abscesses and fistulae causing pain and discharge). However, excessive complications need not be feared if an experienced surgical team is involved.