How are we managing fistulating perianal Crohn's disease? Results of a national survey of consultant gastroenterologists

Frontline Gastroenterology
M J LeepCD Collaborators

Abstract

Fistulating perianal Crohn's disease represents a significant challenge to both clinicians and patients. This survey set out to describe current practice and variation in the medical management of this condition. A survey was designed by an expert group of gastroenterologists and surgeons with an inflammatory bowel disease (IBD) interest. The questionnaire aimed to capture opinions from consultant gastroenterologists with a UK practice on the management of acutely symptomatic fistula, assessment of a new fistula presentation, medical management strategies and surgical intervention. The survey was piloted at the British Society of Gastroenterology Clinical Research Group meeting, and distributed at UK gastroenterology meetings. There were 111 completed responses (response rate 55%). Following clearance of sepsis, 22.1% of respondents would wait 6 weeks or more before commencing medical therapy. Antibiotics were used by 89.2%, with a variable duration. First-line medical therapy was thiopurine for 48% and antitumour necrosis factor (TNF) for 50% of respondents. These were used in combination by 44.4%. Interval to escalation of therapy (if required) varied from 1 month to a year. Anti-TNF therapies were favoured in deteriorating p...Continue Reading

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Jun 3, 2018·Clinical Medicine : Journal of the Royal College of Physicians of London·Gloria Sz TunAlan J Lobo
Mar 2, 2021·World Journal of Gastrointestinal Surgery·Roxanne VilligerBenjamin Misselwitz

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