Medical treatment of perianal crohn disease

Abstract

Crohn disease (CD) can be characterized as inflammatory, stricturing and penetrating/fistulizing phenotype. Perianal fistulae and abscesses are common and are important aspects of this disease. Up to 35% of patients with CD develop at least one fistula in their lifetime. Treatment of perianal CD fistulae has improved greatly over the last 20 years, but requires care of a multi-disciplinary team, consisting of gastroenterologist, colorectal surgeon, radiologist and nurses over a prolonged period of time. Significant progress managing fistulizing CD has been made with the availability of biologics, namely infliximab. This chapter aims to discuss our current knowledge of pediatric perianal/ fistulizing CD, focusing on its' medical management. Gaps in knowledge for the pediatric population will be bridged with available results obtained from adults, findings which have to be used with caution in children.