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Vol. 76, No. 2, 2007
Issue release date: February 2008
Digestion 2007;76:109–112

Fistulizing Crohn’s Disease

Felley C. · Mottet C. · Juillerat P. · Pittet V. · Froehlich F. · Vader J.-P. · Michetti P. · Gonvers J.-J.
aDivision of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, bGastrointestinal Department, University of Basle, Basle, and cHealthcare Evaluation Unit, Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland

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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.

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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