Challenges in Crohn's disease: Complex perianal Crohn's disease

Perianal disease is a particularly morbid phenotype of Crohn's disease with significantly diminished quality of life, affecting up to a third of patients. Medical therapies achieve long term durable remission in only a third of patients. Thus, most undergo operative intervention, at the expense of a risk of incontinence. Mesenchymal stem cell therapy is an emerging therapy without risk of incontinence and improved efficacy as compared to conventional therapy. Additional manifestations of perianal Crohn's disease including hemorrhoids and skin tags are possible to manage operatively, only in the absence of proctitis and anal canal disease.