Crohn's disease is life-long inflammatory bowel disease characterised by chronic inflammation of the gastrointestinal tract anywhere from the mouth to the perianal region. Crohn's follows a relapsing and remitting course, during which active episodes are often protracted.
Causes and risk factors for Crohn's disease
The exact cause of Crohn's disease is unknown; current thinking is that it could be caused by a combination of inter-linking factors which are:
• Previous infection;
• Smoking is an important risk factor and
• patients who smoke also usually
• experience more severe symptoms.
Perianal symptoms of Crohn's disease
A large proportion of Crohn's disease patients suffer from perianal lesions and the distressing associated symptoms. Perianal lesions are considered to be one of the most problematic conditions encountered in colorectal medicine, generally presenting as ulcers, skin tags, fistulae or fissures, or even a combination of these.
• General tenderness of the area.
Perianal symptoms are a common complication of Crohn's disease. A wide range of medicines, including aminosalicylates, steroids, immunosupressants modulators of cytokines and other inflammatory mediators, often in combination, are used to manage Crohn's disease.
However, patients still suffer from perianal flare-ups which may follow a relapsing and remitting course.
Perianal symptoms of Crohn's disease: Treatment aims
Although healing may occur spontaneously, there is significant morbidity. So, for these patients, the treatment aim should be to provide symptomatic relief and improve quality of life during flare-up episodes without affecting treatment of the underlying condition.
This can be achieved with medical or surgical intervention, or both. Medical intervention is the usual first line treatment, as wound healing following surgery is significantly prolonged and can be incomplete.
The aim of a locally applied treatment (ointment) is to provide additional control of symptoms without interfering with management of the underlying condition.