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Education in practice
Current review of the management of fistulising perianal Crohn’s disease
  1. Samuel O Adegbola1,2,
  2. Kapil Sahnan1,2,
  3. Charlene Twum-Barima1,2,
  4. Nusrat Iqbal1,2,
  5. Lillian Reza1,2,
  6. Phillip Lung1,
  7. Janindra Warusavitarne1,2,
  8. Phil Tozer1,2,
  9. Ailsa Hart1,2
  1. 1 St Mark's Hospital and Academic Institute, Harrow, UK
  2. 2 Department of Surgery and Cancer, Imperial College London, London, UK
  1. Correspondence to Dr Samuel O Adegbola, St Mark's Hospital and Academic Institute, Harrow HA13UJ, UK; samadeg{at}


Perianal manifestations of Crohn’s disease constitute a distinct disease phenotype commonly affecting patients and conferring an increased risk of disability and disease burden. Much research has gone into management of fistulising manifestations, with biological therapy changing the landscape of treatment. In this article, we discuss the up-to-date surgical and medical management of perianal fistulas, highlighting current consensus management guidelines and the evidence behind them, as well as future directions in management.

  • crohn's disease
  • gastrointestinal fistulae

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  • Contributors SOA, PT and AH conceptualised the review outline. SOA, KS, CT-B, NI and LR performed the literature review for the manuscript; SOA, KS, CT-B, NI and LR prepared the manuscript; JW, PL, PT and AH have reviewed and revised the manuscript critically, making key directional changes and prepared the final version of the manuscript. All authors approved the final draft prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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