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Anorectal Strictures in Complex Perianal CD: How to Approach?
Amy L Lightner1, Miguel Regueiro2
1Department of Colorectal Surgery, Digestive Disease Surgical Institute, Cleveland Clinic, Cleveland, Ohio.
Clinics in Colon and Rectal Surgery
|January 24, 2022
Summary
Anorectal strictures in Crohn's disease significantly impact quality of life. Treatment involves medical management and endoscopic dilations, but surgery is often necessary for severe cases.
Area of Science:
- Gastroenterology and Colorectal Surgery
Background:
- Anorectal strictures represent a challenging manifestation of perianal Crohn's disease.
- These strictures severely impair patients' quality of life, causing pain, incontinence, and defecation difficulties.
Purpose of the Study:
- To review the current treatment strategies for anorectal strictures in Crohn's disease.
- To highlight the role of medical and endoscopic interventions and the eventual need for surgical options.
Main Methods:
- Review of medical literature on anorectal strictures in Crohn's disease.
- Discussion of therapeutic approaches including medical management, endoscopic dilation, and surgical interventions.
Main Results:
- Medical therapy focuses on controlling luminal disease and mucosal inflammation to mitigate fibrosis.
- Endoscopic interventions, such as serial dilations, can be employed for stricture management.
- A significant percentage of patients ultimately require surgical intervention, including intestinal diversion or proctocolectomy.
Conclusions:
- Anorectal strictures in Crohn's disease present a complex therapeutic challenge.
- While medical and endoscopic treatments are crucial, surgical options remain a necessary component of the management algorithm for many patients.
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