Singh JP, Aleissa M, Drelichman ER, Mittal VK, Bhullar JS. Navigating the complexities of perianal Crohn’s disease: Diagnostic strategies, treatment approaches, and future perspectives. World J Gastroenterol 2024; 30(44): 4745-4753 [DOI: 10.3748/wjg.v30.i44.4745]
Corresponding Author of This Article
Jasneet S Bhullar, MD, MS, FACS, FASCRS, Clinical Associate Professor of Surgery, Department of Surgery, Ascension Providence Hospital, Michigan State University College of Human Medicine, 16001 W Nine Mile Road, Southfield, MI 48075, United States. drjsbhullar@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Nov 28, 2024; 30(44): 4745-4753 Published online Nov 28, 2024. doi: 10.3748/wjg.v30.i44.4745
Navigating the complexities of perianal Crohn’s disease: Diagnostic strategies, treatment approaches, and future perspectives
Jai P Singh, Maryam Aleissa, Ernesto R Drelichman, Vijay K Mittal, Jasneet S Bhullar
Jai P Singh, Department of Surgery-Colon and Rectal Surgery, Ascension Providence Hospital, Southfield, MI 48075, United States
Maryam Aleissa, Ernesto R Drelichman, Department of Surgery-Colon and Rectal Surgery, Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States
Vijay K Mittal, Jasneet S Bhullar, Department of Surgery, Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States
Author contributions: Singh JP wrote the manuscript, and conducted the majority of the research, including the paper’s design, resource review, and manuscript preparation; Aleissa M assisted in writing; Drelichman ER and Mittal VK contributed to the paper; Bhullar JS designed the research and wrote the paper, answered any questions from readers, leveraging his extensive expertise to provide comprehensive responses and further insights.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jasneet S Bhullar, MD, MS, FACS, FASCRS, Clinical Associate Professor of Surgery, Department of Surgery, Ascension Providence Hospital, Michigan State University College of Human Medicine, 16001 W Nine Mile Road, Southfield, MI 48075, United States. drjsbhullar@gmail.com
Received: August 9, 2024 Revised: September 25, 2024 Accepted: October 24, 2024 Published online: November 28, 2024 Processing time: 95 Days and 3.1 Hours
Abstract
This article discusses the literature review article by Pacheco et al published in July 2024; the authors provided good reviews of perianal Crohn’s disease (CD), and challenges faced by clinicians in the management. CD, characterized by its chronic and relapsing nature, is an idiopathic condition that can involve any segment of the gastrointestinal tract. Perianal disease impacts up to 40% of patients with CD, with perianal fistulas constituting up to 80% of perianal lesions. Perianal CD can be highly incapacitating and profoundly diminish the overall well-being of patients. The management focuses on controlling the perianal sepsis and treating luminal CD. Biologics are crucial to the treatment approach, and results have been encouraging. The surgery focuses on controlling the sepsis, with more definitive treatments being fistula surgery, fecal diversion, and proctectomy as the last resort. This manuscript briefly describes the burden of CD, the challenges posed by perianal CD, and the role of different treatment modalities from colorectal surgeon’s perspective.
Core Tip: Perianal disease affects a significant number of Crohn’s patients. Perianal fistulizing Crohn’s disease can be very debilitating and adversely affect the quality of life. These patients are primarily managed through a multidisciplinary approach. This editorial provides a detailed analysis of current management strategies for perianal diseases in Crohn’s patients and an analysis of the literature by Pacheco et al.
