Journal
DIGESTION
Volume 76, Issue 2, Pages 109-112Publisher
KARGER
DOI: 10.1159/000111024
Keywords
Crohn's disease; fistula; antibiotics; azathioprine; infliximab; methotrexate; cyclosporine; tacrolimus; internal fistulas, surgery
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Fistulas are common in Crohn's disease. A population-based study has shown a cumulative risk of 33% after 10 years and 50% after 20 years. Perianal fistulas were the most common (54%). Medical therapy is the main option for perianal fistula once abscesses, if present, have been drained, and should include antibiotics (both ciprofloxacin and metronidazole) and immunomodulators. Infliximab should be reserved for refractory patients. Surgery is often necessary for internal fistulas. Copyright (C) 2008 S. Karger AG, Basel.
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