Medical-surgical Combined Approach in Perianal Fistulizing Crohn's Disease (CD): Doing it Together

Author(s): Kapil Sahnan* , Samuel O Adegbola , Ana Fareleira , Ailsa Hart , Janindra Warusavitarne .

Journal Name: Current Drug Targets

Volume 20 , Issue 13 , 2019

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Graphical Abstract:


Abstract:

Fistulising perianal Crohn’s disease (pCD) is an aggressive phenotype, and patients not only suffer from perianal manifestations but also a worsening course for their luminal disease. This article describes the 6 key steps clinicians need to consider when managing patients with pCD which include; (i) ensuring a prompt diagnosis, (ii) multi-disciplinary management, (iii) psychological support, (iv) using multimodal medical and surgical treatment strategies, (v) continually monitoring and optimising therapy and (vi) ensuring that patients have a way of accessing care if required. Patients with fistulising pCD often have an unpredictable disease course and complete remission can be elusive. As such, a considered and nuanced approach is essential keeping the wider multi-disciplinary team and the patient involved in all decision making.

Keywords: Crohn's disease, perianal, surgery, medical therapy, luminal disease, optimising therapy.

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Article Details

VOLUME: 20
ISSUE: 13
Year: 2019
Page: [1373 - 1383]
Pages: 11
DOI: 10.2174/1389450120666190520103454
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