Medical options for treating perianal Crohn's disease.
Perianal Crohn's disease can cause significant morbidity for patients affected by the disease. However, diagnostic modalities and treatment options have progressed changing the goals of treatment from fistula "improvement" to complete cessation of drainage. Fistula closure and fibrosis of the fistula track is achieved in some patients. Furthermore, treatment has become a combined effort between medical physicians and surgeons. Simple disease can be treated with medical therapy alone consisting of antibiotics and immunomodulators. Infliximab should be added to refractory simple disease or simple disease with the presence of inflammation. If complex fistula disease is evident a surgical evaluation should also be done to determine if intervention is indicated. Complex disease should be treated with antibiotics, immunomodulators and biologic therapy from the onset. This review will summarise current data regarding medical options for treatment of fistulising Crohn's disease.
Griggs
L
L
Inflammatory Bowel Disease Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Schwartz
D A
DA
D000465:Algorithms; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001004:Anus Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003226:Congresses as Topic; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents