Kim Isaacs, MD, on Management of Perianal Crohn Disease

Kim Isaacs, MD, discusses her presentation on managing perianal disease in patients with Crohn disease, which she gave at the September 12 virtual regional meeting of Advances in Inflammatory Bowel Disease. 

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Kim Isaacs, MD, is professor of medicine at the University of North Carolina at Chapel Hill.


Kim Isaacs:  Hello. My name is Kim Isaacs. I am professor of medicine at the University of North Carolina at Chapel Hill. I want to thank you for participating in the AIBD regional course today. I had the opportunity of speaking about perianal disease in patients with Crohn's disease.

We started out by going through the differential diagnosis of perianal Crohn's disease. We need to consider things like actual fistulizing disease, abscesses, hidradenitis suppurativa, and cutaneous Crohn's disease as we're evaluating these patients.

Perianal Crohn's disease is one of the more debilitating manifestations of Crohn's disease. I hope that by listening today, that you have gained a perspective on what to look for, how to evaluate, and how to treat patients.

We started off by looking at baseline assessment, including a history and physical examination, an endoscopic assessment, luminal activity, and imaging techniques concentrating on MRI imaging. We divided these patients up into those patients with abscesses and those with stenosis to further define simple and complex fistulizing disease.

We then went into some of the debridement and operative options for these patients as well as medical options including antibiotics, immune active therapy, and biologic therapy. I hope that you have a better idea of how to manage these patients after this presentation today. Thank you.