ABSTRACT
Crohn’s disease (CD) is characterized by chronic focal or segmental, transmural, persistent and progressive inflammation, which can progress despite the absence of symptoms, culminating with intestinal lesions and complications such as strictures, abscesses and fistulas. A more detailed assessment of the deep healing of perianal fistulas in CD patients with clinical data and imaging methods, i.e. deep remission, should be the target for monitoring and evaluation. Corticosteroids and 5-amino salicylic acid derivatives are not effective in controlling fistulizing disease, although they may be used in the treatment of luminal disease. The effectiveness of immunosuppressants in fistulizing perianal CD has been suggested by meta-analysis of controlled trials in which the healing of fistulas is assessed as a secondary endpoint. It can be concluded that low rate of healing, long time required for therapeutic response, side effects and high recurrence rate are factors that limit the use of immunosuppressants in perianal fistulizing CD.
