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Clin Colon Rectal Surg 2022; 35(01): 021-031
DOI: 10.1055/s-0041-1740035
Review Article

The Essential Role of a Multidisciplinary Approach in Inflammatory Bowel Diseases: Combined Medical-Surgical Treatment in Complex Perianal Fistulas in CD

Jeroen Geldof
1   IBD Unit, St. Mark's Hospital, Harrow, United Kingdom
2   Gastroenterology Department, University Hospital Ghent, Ghent, Belgium
,
Nusrat Iqbal
3   Robin Phillips Fistula Research Unit, St. Mark's Hospital, Harrow, United Kingdom
,
Janindra Warusavitarne
3   Robin Phillips Fistula Research Unit, St. Mark's Hospital, Harrow, United Kingdom
,
Ailsa Hart
1   IBD Unit, St. Mark's Hospital, Harrow, United Kingdom
3   Robin Phillips Fistula Research Unit, St. Mark's Hospital, Harrow, United Kingdom
› Author Affiliations Funding None.
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Abstract

Perianal fistulizing Crohn's disease (PFCD) represents a challenging and complex disease phenotype. Patients typically suffer a more severe disease course than those without perianal complications and are often managing debilitating symptoms. Etiology is understood to be multifactorial, with genetic predisposition, microbiological insult, aberrant immunity, and mechanical factors all implicated. As a result, multimodal treatment strategies must be employed to achieve disease control and fistula closure. This requires the complimentary involvement of medical and surgical disciplines in order to ensure thorough assessment and treatment tailored to the individual scenario and patient goals. The aim of this article is to describe an overview of the various treatment strategies available for PFCD, focusing on how a synergistic approach is required to ensure maximal chances of success.

Keywords

Crohn's disease - PFCD - perianal fistula - multidisciplinary treatment


Publication History

Article published online:
17 January 2022

© 2022. Thieme. All rights reserved.

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