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Management of Perianal Fistulas Associated with Crohn Disease: A Nurse's Perspective
Kay Greveson1, Ola Haj, Ailsa Hart
1About the authors: Kay Greveson, RN, is at The London IBD Clinic, London, United Kingdom; Ola Haj, RN, MPH, is at the IBD Clinic, Gastroenterology Department, Sheba Medical Center, Derech Sheba 2, Ramat Gan, Israel; Ailsa Hart, MD, PhD, is a Professor at the IBD Department, St Mark's Hospital, Harrow, London, United Kingdom; Parnia Geransar, BPharm, PhD, was a Senior Global Medical Director, Global Medical Affairs - Rare GI at Takeda Pharmaceuticals International AG, Glattpark-Opfikon, Zurich, Switzerland at the time of manuscript development; and Oded Zmora, MD, is a Professor at the Department of Surgery, Shamir Medical Center, Be'er Ya'akov, Tel Aviv, Israel.
Abstract:
Crohn disease perianal fistulas are associated with considerable morbidity and impaired quality of life. Nurses who specialize in inflammatory bowel disease (IBD) play a vital role in the management of Crohn disease perianal fistulas from diagnosis to long-term care; however, there is little evidence available to inform Crohn associated perianal fistula management strategies for nurses. This narrative review aims to provide IBD nurses with an up-to-date overview of Crohn perianal fistulas. It discusses the vital role IBD nurses play within the multidisciplinary team; the physical, social, and psychological impacts of Crohn perianal fistulas on patients; available treatment options; and how IBD nurses can support patients in their perianal fistula journey to enable optimum outcomes for patients. It also reviews diagnostic techniques and IBD nurses' involvement in Crohn perianal fistula diagnosis. While this article is aimed at IBD nurses, it is relevant to all nurses irrespective of their role (unit, clinic, community, and stoma) who interact with patients with Crohn perianal fistulas because awareness of the signs and symptoms of this condition will enable timely referrals and diagnosis.
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