Anorectal Crohn’s Disease
- Control sepsis: Infection must be addressed before starting immunosuppressive medications.
- Treat underlying luminal disease and control diarrhea, but avoid steroids for perianal Crohn’s disease.
- Perineal care: Perineal hygiene should include gentle cleansing with sitz baths or showers and skin protection with barrier creams.
- Avoid surgery in patients who are asymptomatic or in the setting of active proctitis.
- In patients who are optimized, fistulas may be treated with long-term draining setons, advancement flaps, or LIFT.
- Skin tags or hemorrhoids should generally not be treated.
- Diversion may appropriate as component of the management of perianal Crohn’s disease for some patients.
There's more to see -- the rest of this topic is available only to subscribers.
Last updated: January 26, 2022
Steinhagen, Emily, and Andrea C Bafford. "Anorectal Crohn’s Disease." ASCRS Textbook of Colon and Rectal Surgery, 2022. ASCRS U, www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285042/all/Anorectal_Crohn_s_Disease.
Steinhagen E, Bafford AC. Anorectal Crohn’s Disease. ASCRS Textbook of Colon and Rectal Surgery. 2022. https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285042/all/Anorectal_Crohn_s_Disease. Accessed May 28, 2023.
Steinhagen, E., & Bafford, A. C. (2022). Anorectal Crohn’s Disease. In ASCRS Textbook of Colon and Rectal Surgery https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285042/all/Anorectal_Crohn_s_Disease
Steinhagen E, Bafford AC. Anorectal Crohn’s Disease [Internet]. In: ASCRS Textbook of Colon and Rectal Surgery. ; 2022. [cited 2023 May 28]. Available from: https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285042/all/Anorectal_Crohn_s_Disease.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Anorectal Crohn’s Disease ID - 2285042 A1 - Steinhagen,Emily, AU - Bafford,Andrea, Y1 - 2022/01/26/ BT - ASCRS Textbook of Colon and Rectal Surgery UR - https://www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285042/all/Anorectal_Crohn_s_Disease DB - ASCRS U DP - Unbound Medicine ER -