Fistulizing Crohn's disease |
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| Authors: | Felley Christian Mottet Christian Juillerat Pascal Pittet Valérie Froehlich Florian Vader John-Paul Michetti Pierre Gonvers Jean-Jacques |
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| Institution: | Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. christian.felley@chuv.ch |
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| Abstract: | 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. |
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