Current opinion on the therapy of perianal fistulas in patients with Crohn’s disease
Authors:
M. Bortlík
Authors‘ workplace:
Klinické a výzkumné centrum pro střevní záněty, ISCARE Lighthouse a Interní klinika 1. LF UK a ÚVN Praha
Published in:
Gastroent Hepatol 2013; 67(1): 25-29
Category:
IBD: Review Article
Overview
Perianal fistulas affect more than one third of patients suffering from Crohn’s disease. They represent severe phenotype of the disease and substantially decrease the quality of life in affected patients. Therapy requires a complex approach with combination and appropriate coordination of medical treatment and surgical techniques. Using the current medicines, especially biologics, as well as propper surgery, we can achieve the long-term healing in more than 2/3 of patients with perianal Crohn’s disease.
Key words:
fistula – Crohn’s disease – abscess – infliximab – adalimumab
The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the article.
The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.
Submitted:
28. 1. 2013
Accepted:
14. 2. 2013
Sources
1. Tozer PJ, Burling D, Gupta A et al. Review article: medical, surgical and radiological management of perianal Crohn’s fistulas. Aliment Pharmacol Ther 2011; 33(1): 5–22.
2. Keshaw H, Foong KS, Forbes A et al. Perianal fistulae in Crohn’s disease: Current and future approaches to treatment. Inflamm Bowel Dis 2010; 16(5): 870–880.
3. Schwartz DA, Pemberton JH, Sandborn WJ. Diagnosis and treatment of perianal fistulas in Crohn’s disease. Ann Intern Med 2001; 135(10): 906–918.
4. Sandborn WJ, Fazio VW, Feagan BG et al. AGA technical review on perianal Crohn’s disease. Gastroenterology 2003; 125(5): 1508–1530.
5. Satsangi J, Silverberg MS, Vermeire S et al. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006; 55(6): 749–753.
6. Ng SC, Plamondon S, Gupta A et al. Prospective evaluation of anti-tumor necrosis factor therapy guided by magnetic resonance imaging for Crohn’s perineal fistulas. Am J Gastroenterol 2009; 104(12): 2973–2986.
7. Thia KT, Mahadevan U, Feagan BG et al. Ciprofloxacin or metronidazole for the treatment of perianal fistulas in patients with Crohn’s disease: a randomized, double-blind, placebo-controlled pilot study. Inflamm Bowel Dis 2009; 15(1): 17–24.
8. Pearson DC, May GR, Fick GH et al. Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis. Ann Intern Med 1995; 123(2): 132–142.
9. Dejaco C, Harrer M, Waldhoer T et al. Antibiotics and azathioprine for the treatment of perianal fistulas in Crohn’s disease. Aliment Pharmacol Ther 2003; 18(11–12): 1113–1120.
10. Present DH, Rutgeerts P, Targan S et al. Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med 1999; 340(18): 1398–1405.
11. Sands BE, Anderson FH, Bernstein CN et al. Infliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med 2004; 350(9): 876–885.
12. Bouguen G, Siproudhis L, Gizard E et al. Long-term outcome of perianal fistulizing Crohn’s disease treated with infliximab. Clin Gastroent Hepatol 2013 [Epub ahead of print].
13. Colombel JF, Sandborn WJ, Rutgeerts P et al. Adalimumab for maintenance of clinical response and remission in patients with Crohn’s disease: the CHARM trial. Gastroenterology 2007; 132(1): 52–65.
14. Colombel JF, Schwartz DA, Sandborn WJ et al. Adalimumab for the treatment of fistulas in patients with Crohn’s disease. Gut 2009; 58(7): 940–948.
15. Lukáš M, Bortlík M. Adalimumab v léčbě perianálních píštělí u Crohnovy nemoci. Komentovaný referát k post hoc analýze studií CHARM a ADHERE. Remedia 2009; 19: 376–380.
16. Bortlík M, Ďuricová D, Kohout P et al. Doporučení pro podávání biologické terapie u idiopatických střevních zánětů: 2. vydání. Gastroent Hepatol 2012; 66(1): 12–22.
17. Šerclová Z, Ryska O, Kalvach J et al. Eradikace perianálních píštělí u nemocných s ISZ metodou Advancement Flap. Gastroent Hepatol 2012; 66 (Suppl 2): S22.
Labels
Paediatric gastroenterology Gastroenterology and hepatology SurgeryArticle was published in
Gastroenterology and Hepatology
2013 Issue 1
Most read in this issue
- Segmental portal hypertension
- Current opinion on the therapy of perianal fistulas in patients with Crohn’s disease
- Perforated gangrenous cholecystitis
- Dysfunction of upper gastrointestinal tract in critically ill patients: current view and prospects