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Clin Colon Rectal Surg 2022; 35(01): 044-050
DOI: 10.1055/s-0041-1740037
Review Article

Anorectal Strictures in Complex Perianal CD: How to Approach?

Amy L. Lightner
1   Department of Colorectal Surgery, Digestive Disease Surgical Institute, Cleveland Clinic, Cleveland, Ohio
,
Miguel Regueiro
2   Department of Gastroenterology, Digestive Disease Surgical Institute, Cleveland Clinic, Cleveland, Ohio
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Abstract

Anorectal strictures are a notoriously difficult to treat phenotype of perianal Crohn's disease. Quality of life is diminished due to ongoing pain, incontinence, difficulty with stool evacuation, and recurrent medical and surgical treatments. Medical therapy is aimed at treating luminal disease and mucosal ulceration to prevent worsening of fibrosis. Clinical examination and endoscopic intervention can be used for serial dilations of strictures. Unfortunately, despite optimal medical therapy and endoscopic intervention with serial anal dilations, surgery with intestinal diversion or proctocolectomy may be required as part of the treatment algorithm in a significant proportion of patients.

Keywords

anal canal disease - anal stenosis - proctocolectomy


Publication History

Article published online:
17 January 2022

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