Advances in Perianal Disease Associated with Crohn's Disease-Evolving Approaches

Xinying Wang; Bo Shen

doi:10.1016/j.giec.2019.02.011

Advances in Perianal Disease Associated with Crohn's Disease-Evolving Approaches

Gastrointest Endosc Clin N Am. 2019 Jul;29(3):515-530. doi: 10.1016/j.giec.2019.02.011.

Authors

Xinying Wang¹, Bo Shen²

Affiliations

¹ Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
² The Center for Inflammatory Bowel Diseases-A31, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address: shenb@ccf.org.

PMID: 31078250
DOI: 10.1016/j.giec.2019.02.011

Abstract

Perianal diseases, common complications of Crohn's disease, are difficult to diagnose/manage. Patients with perianal Crohn's disease suffer from persistent pain and drainage, recurrent perianal sepsis, impaired quality of life, and financial burden. Conventional medical and surgical therapies carry risk of infection, myelosuppression, incontinence, disease recurrence. Although the phenotype of Crohn's disease has been extensively studied, reported outcomes are inconsistent. Endoanal ultrasonography is also becoming popular because of low cost and ability to acquire images in real time. Emerging management strategies for treatment including laser therapy, local injection of agents, use of hyperbaric oxygen, and stem cell therapy, have demonstrated efficacy.

Keywords: Crohn's disease; Endoscopic therapy; Fistula; Perianal disease; Stem cells.

Publication types

Review

MeSH terms

Anus Diseases / diagnosis*
Anus Diseases / etiology
Anus Diseases / therapy
Cost of Illness
Crohn Disease / complications*
Crohn Disease / diagnostic imaging
Endosonography / methods
Humans
Recurrence