{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T01:59:30Z","timestamp":1791165570738,"version":"4.1.0"},"reference-count":111,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2010,10,29]],"date-time":"2010-10-29T00:00:00Z","timestamp":1288310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:sec><jats:label\/><jats:p> <jats:italic>Aliment Pharmacol Ther<\/jats:italic> 2011; <jats:bold>33:<\/jats:bold> 5\u201322<\/jats:p><\/jats:sec><jats:sec><jats:title>Summary<\/jats:title><jats:p><jats:bold>Background\u2002<\/jats:bold> Crohn\u2019s anal fistulas are common and cause considerable morbidity. Their management is often difficult; medical and surgical treatments rarely lead to true healing with frequent recurrence and complications.<\/jats:p><jats:p><jats:bold>Aim\u2002<\/jats:bold> To examine medical treatments previously and currently used, surgical techniques and the important role of optimal imaging.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> We conducted a literature search in the Pub Med database using Crohn\u2019s, Anal Fistula, Surgery, Imaging and Medical Treatment as search terms.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Antibiotics and immunosuppressants have a role, but slow initial response, side effects and relatively low remission rates of up to around a third with frequent recurrence limit their value. Long\u2010term infliximab produces clinical remission in 36\u201358% of patients with combined medical and surgical management achieving optimal outcomes. Traditional and newer surgical procedures often have a high rate of recurrence with a significant risk of temporary or, in up to 10% of cases, permanent stomas, incontinence and unhealed or slowly healing wounds in 30%.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Management of Crohn\u2019s anal fistulas remains challenging. Established principles are to drain infection, use setons as required, aggressively manage active proctitis, give antibiotics, immunosuppressants and employ anti\u2010TNF\u03b1 therapy, and they demand significant co\u2010operation between gastroenterologists and surgeons.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2036.2010.04486.x","type":"journal-article","created":{"date-parts":[[2010,10,29]],"date-time":"2010-10-29T13:03:42Z","timestamp":1288357422000},"page":"5-22","source":"Crossref","is-referenced-by-count":89,"title":["Review article: medical, surgical and radiological management of perianal Crohn\u2019s fistulas"],"prefix":"10.1111","volume":"33","author":[{"given":"P. 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