What is fistulising Crohn’s disease?

Crohn’s disease may be complicated by the formation of fistulae (abnormal tunnels between the bowel and other structures), which may develop between two segments of bowel (enteroenteric), between the rectum and the vagina (rectovaginal), between the bowel and the bladder (enterovesicular) or between the bowel and the skin (enterocutaneous). Perianal fistulae (affecting the areas around the anus) are the most common type.

Fistulae develop in approximately one third of patients with Crohn’s disease.1

People with fistulising Crohn’s disease typically experience periods of disease activity (flare ups) and periods of inactivity (remission), and cycle between these two states. Symptoms during a flare up can include diarrhoea, abdominal pain or discomfort, fever, nausea, vomiting, tiredness and weight loss. The fistula may also drain pus or a foul-smelling discharge.

People may go into remission following treatment, but most symptoms eventually return.

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Reference: 1. Sands B et al. Clin Gastroenterol Hepatol 2004; 2: 912–920.