Results of the fifth scientific workshop of the ecco [ii]: Clinical aspects of perianal fistulising crohn's disease-the unmet needs

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Abstract

Background and Aims: Perianal fistulas affect up to one-third of Crohn's patients during the course of their disease. Despite the considerable disease burden, current treatment options remain unsatisfactory. The Fifth Scientific Workshop [SWS5] of the European Crohn's and Colitis Organisation [ECCO] focused on the pathophysiology and clinical impact of fistulas in the disease course of patients with Crohn's disease [CD]. Methods: The ECCO SWS5 Working Group on clinical aspects of perianal fistulising Crohn's disease [pCD] consisted of 13 participants, gastroenterologists, colorectal surgeons, and a histopathologist, with expertise in the field of inflammatory bowel diseases. A systematic review of literature was performed. Results: Four main areas of interest were identified: Natural history of pCD, morphological description of fistula tracts, outcome measures [including clinical and patient-reported outcome measures, as well as magnetic resonance imaging] and randomised controlled trials on pCD. Conclusions: The treatment of perianal fistulising Crohn's disease remains a multidisciplinary challenge. To optimise management, a reliable classification and proper trial endpoints are needed. This could lead to standardised diagnosis, treatment, and follow-up of Crohn's perianal fistulas and the execution of well-designed trials that provide clear answers. The prevalence and the natural history of pCD need further evaluation.

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Gecse, K. B., Sebastian, S., de Hertogh, G., Yassin, N. A., Kotze, P. G., Reinisch, W., … Bemelman, W. A. (2016). Results of the fifth scientific workshop of the ecco [ii]: Clinical aspects of perianal fistulising crohn’s disease-the unmet needs. Journal of Crohn’s and Colitis, 10(7), 758–765. https://doi.org/10.1093/ecco-jcc/jjw039

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