New alternatives for the treatment of fistulas in Crohn's disease

The authors refer on the combination of the administration of artificial nutrition with enterohormone Somatostatin in a group of 16 patients with Crohn's disease (CD), complicated by the occurrence of fistulas. The sole administration of total parenteral or enteral nutrition led in each case to a significant reduction of secretion from the fistulas, and in two cases to their complete closing. Apart from this, the nutritional status of the patients improved. The administration of Somatostatin i.v. in the form of the preparation Stilamin led to a further reduction of secretion from the fistulae. Complete closing of the fistulae due to a combination of total parenteral nutrition (TPN) or total enteral nutrition (TEN) and Stilamin, was achieved in only 2 patients, but the combination use of tissue sealant Histoacryle with the treatment resulted in a closure of the fistulas in a further 2 patients. Altogether the application of this treatment resulted in closing 6 fistulas (37.5%). The authors consider that the above mentioned methods can open new prospectives, but this requires further experience.