In this clinical perspective, David A. Schwartz, MD, discusses evolving treatment strategies for perianal fistulizing Crohn’s disease, emphasizing early advanced therapy and coordinated medical-surgical management. Anti-TNF agents, particularly infliximab, remain the best-established treatment option. The American Gastroenterological Association’s broader guidance supporting earlier advanced therapy in moderate-to-severe Crohn’s disease reinforces the need to avoid prolonged ineffective conventional treatment, although it does not introduce new fistula-specific recommendations. For active fistulas without an abscess, combining a biologic with an antibiotic is recommended for induction of remission.
Keep Reading
Add A Comment