Fistulizing Crohn's disease.
Fistulas are common in Crohn's disease. A population-based study has shown a cumulative risk of 33% after 10 years and 50% after 20 years. Perianal fistulas were the most common (54%). Medical therapy is the main option for perianal fistula once abscesses, if present, have been drained, and should include antibiotics (both ciprofloxacin and metronidazole) and immunomodulators. Infliximab should be reserved for refractory patients. Surgery is often necessary for internal fistulas.
Felley
Christian
C
Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. christian.felley@chuv.ch
Mottet
Christian
C
Juillerat
Pascal
P
Pittet
Valérie
V
Froehlich
Florian
F
Vader
John-Paul
JP
Michetti
Pierre
P
Gonvers
Jean-Jacques
JJ
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003424:Crohn Disease / Q000150:complications* / Q000628:therapy; D013505:Digestive System Surgical Procedures / Q000379:methods; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D011350:Proctocolitis / Q000150:complications / Q000628:therapy; D012003:Rectal Fistula / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D000069285:Infliximab