Treatment Algorithms for Crohn's Disease

 

Re-written summaries by: Anuva Gajjar

Date Published: 1/13/2021

Original research links:

https://pubmed.ncbi.nlm.nih.gov/32172251/

Introduction:

Crohn's disease (CD) is a chronic inflammatory bowel disease that can affect any part of the digestive tract. It is characterized by the presence of inflammatory lesions, called ulcers, in the lining of the gastrointestinal tract. These ulcers can cause symptoms such as abdominal pain, diarrhea, and malnutrition. CD can also lead to complications such as fistulas, which are abnormal connections between different organs or tissues. Fistulas can be simple or complex, and their treatment depends on their type and location.

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Methods:

The treatment of fistulas in CD patients often involves a combination of medical and surgical approaches. Medical treatment may include the use of antibiotics, anti-inflammatory medications, and immune-modulating agents. Surgical treatment may involve drainage of abscesses, fistulotomy (the surgical removal of the fistula), or fistulectomy (the surgical removal of the fistula and surrounding tissue). The choice of treatment depends on the type and location of the fistula, as well as the patient's overall health and preferences.

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Results:

A recent systematic review and meta-analysis of 27 controlled trials found moderate-quality evidence to support the use of tumor necrosis factor (TNF) inhibitors in the treatment of fistulas in CD patients. These medications, which include adalimumab and infliximab, have been shown to be effective in inducing fistula remission. However, there is limited evidence on their effectiveness in maintaining remission. Other medications, such as antibiotics and immunosuppressants, have also been used in the treatment of fistulas, but their effectiveness is uncertain.

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Conclusion:

The treatment of fistulas in CD patients is a complex and challenging process that often requires a combination of medical and surgical approaches. While TNF inhibitors have been shown to be effective in inducing fistula remission, more research is needed to determine their long-term effectiveness and safety. It is important for CD patients with fistulas to work closely with their healthcare team to determine the most appropriate treatment plan.