Healing of perineal Crohn's disease with metronidazole

Does Infliximab Infusion Impact Results of Operative Treatment for Crohn's Perianal Fistulas?

“…Medical therapy has demonstrated limited efficacy with relapse after cessation of treatment. [22][23][24][25][26][27][28][29][30][31][32] Operative treatment has shown good results [33][34][35] but puts the patient at an increased risk for fecal incontinence.…”

Rectovaginal Fistula in Crohn's Disease

“…Evidence on fistulous disease remains anecdotal and based on outcome analysis from small observational studies. 18,19 Metronidazole reduces the bacteroides content of the colon and has immunosuppressive effects, but its effects rapidly wear off when it is stopped. Brandt et al 18 treated 26 patients with perianal Crohn_s disease with 20 mg/kg metronidazole daily; 10 patients progressed to complete healing and the remainder had partial healing.…”

Fistulating Anal Crohn's Disease: Results of Combined Surgical and Infliximab Treatment

“…1 Spontaneous healing has been reported by Alexander-Williams and Buchmann. 2 Small or uncontrolled trials reported healing of up to 83 percent with medical treatments, including metronidazole, 3 azathioprine, 4 and 6-mercaptopurine. 5 However, fistula recurrence rate has been shown to be high after treatment was stopped.…”

“…5 However, fistula recurrence rate has been shown to be high after treatment was stopped. 3 Surgical approaches include conventional fistulotomy, long-term seton drainage, and various advancement flap repairs. In recent years, infliximab, an IgG1 murine-human chimeric monoclonal antibody to tumor necrosis factor (TNF)-alpha, has been reported to close 46 percent of fistula in Crohn's disease.…”