Treatment of Fistulising Crohn’s disease

The severity of Fistulising Crohn’s disease varies between individuals. To treat your Crohn’s disease in the best possible way, your doctor will need to determine how severe your symptoms are.

The therapeutic goals of management of Fistulising Crohn’s disease are to close fistulae, maintain their closure, reduce infection and limit the need for surgical intervention. As Fistulising Crohn’s disease is a life-long condition, it is important that you work with your doctor to find the treatment that works best for you and allows you to lead a fulfilling life.

Several drug types, such as anti-inflammatory drugs, corticosteroids, immunosuppressants, antibiotics or biologics, for single or combination therapy are available for the treatment of Fistulising Crohn’s disease. Other drugs may also be given to help you relax or to relieve pain, diarrhoea or infection. Your doctor will fully assess your condition before deciding on your individual treatment course.

When treating mild to moderate inflammation, doctors often prescribe anti-inflammatory drugs known as aminosalicylates, which contain 5-aminosalicyclic acid (5-ASA). Corticosteroids, also known as steroids, may be used to treat moderate to severe Fistulising Crohn’s disease or to treat patients who do not respond to 5-ASA drugs. Immunosuppressants (or immunomodulators) are generally prescribed when 5-ASAs or corticosteroids have failed and for patients with more moderate to severe disease. Another treatment option is biologics, which work by targeting specific biological proteins involved in chronic inflammation. In Fistulising Crohn’s disease, biologics such as the antibodies against tumour necrosis factor (TNF-α) work by blocking the immune system’s production of TNF-α, a cytokine, which intensifies inflammation. They can only be prescribed by a gastroenterologist, are administered intravenously or subcutaneously and are generally only offered once a patient has failed to improve on standard therapy.

For some people with Fistulising Crohn’s disease, surgery may be necessary in combination with medication. Surgery is only considered after consultation with your gastroenterologist and a surgeon.

If you have any further questions about your treatment options please contact your doctor.