Occurrence and outcome after primary treatment of anal fistulae in Crohn's disease.

Abstract

suMMARY During the period 1955 to 1974 inclusive, 826 patients developed Crohn's disease and were registered citizens of Stockholm County at the time of definite diagnosis. These patients were followed up and investigated with reference to the occurrence of and outcome after treatment for anal fistulae. These fistulae were recorded in 184 patients (23 %/.). The incidence of anal fistulae increased the further distally the intestinal lesion was located. Healing followed local operation for anal fistula before curative intestinal resection in approximately 60% of the patients with small intestinal and combined ileocolic disease. However, patients with colonic Crohn's disease did not heal after such treatment. When curative intestinal resection was the primary procedure, 47 % of the patients healed spontaneously. Small intestinal and combined ileocolic disease was associated with a good prognosis-90 % were healed at follow-up,

CARD15 Mutations and Perianal Fistulating Crohn’s Disease: Correlation and Predictive Value of Antibiotic Response

“…Patients with colonic CD, particularly those with rectal involvement, have significantly higher incidence of perianal fistulas than patients without colonic involvement [2]. Indeed, only 12% of patients with isolated ileal disease develop perianal fistulas, compared with 92% of patients with rectal involvement [2]. These results were recently corroborated by a large cross-sectional study carried out in our country [5].…”

“…Perianal fistulas are a common manifestation of CD that can lead to significant morbidity and even proctectomy [1][2][3][4].…”

“…It may be thought that the best response to antibiotics observed in these patients could be related to factors other than CARD15 genotype [2,[42][43][44]. This was ruled out by demonstrating no significant differences between patients with and without CARD15 variants in relation to other factors with a OR odds ratio, CI confidence interval * Calculated for the probability of response to antibiotics in patients without mutations compared with patients with mutations Dig Dis Sci potential effect on the response.…”

“…The risk of developing Crohn 0 s perianal fistulas increases when the disease involves the distal bowel. Patients with colonic CD, particularly those with rectal involvement, have significantly higher incidence of perianal fistulas than patients without colonic involvement [2]. Indeed, only 12% of patients with isolated ileal disease develop perianal fistulas, compared with 92% of patients with rectal involvement [2].…”

“…Up to 43% of CD patients will develop perianal fistulas, with a significant increase of disability and direct and indirect costs, and a decrease in perceived quality of life [1][2][3][4]. The risk of developing Crohn 0 s perianal fistulas increases when the disease involves the distal bowel.…”