Immunotherapy Research Journal

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Anoperineal Disease

The most current population-based series [from Sweden and Minnesota] have found that anoperineal involvement is seen in 14% to 38% of patients with Crohn’s disease, with isolated perianal disease seen in just 5%. The prevalence of perianal manifestations increases because the disease progresses distally, with only 15% of patients with ileocolic Crohn’s disease developing fistula but fistulae occurring in 92% of patients with Crohn’s disease involving the colon and rectum. There doesn't appear to be a predilection for age, with between 13% and 62% of youngsters and adolescents with Crohn’s disease experiencing perianal manifestations; however, a younger age of onset increases the chances of developing perianal disease over time. Perianal Crohn’s disease is usually recurrent, with 35% to 59% of patients relapsing within 2 years. Quite 80% of patients require surgery, and as many as 31% require a permanent stoma. The presence of perianal disease is related to a more disabling explanation, with increased extraintestinal manifestations and greater steroid resistance. Large studies have also shown an increased risk for epithelial cell carcinoma and adenocarcinoma of the anus in patients with anorectal involvement.

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