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Die Therapie des komplizierten Morbus Crohn


Scharl, Michael; Barthel, Christiane; Rogler, Gerhard (2014). Die Therapie des komplizierten Morbus Crohn. Praxis, 103(6):323-327.

Abstract

During their disease course, the majority of Crohn's disease patients will develop a complicated disease which is characterized by the occurrence of fistulas and/or stenosis. Symptomatic, perianal fistulas should be surgically drained before anti-inflammatory therapy will be initiated. Antibiotics, such as metronidazole, improve disease symptomatic however, they are not sufficient to induce continuous fistula closure. For this purpose, azathioprine/6-mercaptopurine as well as anti-TNF antibodies are useful when administered continuously. Surgical options include seton drainage, fistula excision, fistula plugs and mucosa flaps. As ultima ratio, temporary ileostomy and proctectomy are to be discussed. Non-perianal fistulas often require surgical approaches. Symptomatic strictures or stenosis can be treated by anti-inflammatory medications (only if they are cause by inflammation), endoscopic balloon dilatation or surgery.

During their disease course, the majority of Crohn's disease patients will develop a complicated disease which is characterized by the occurrence of fistulas and/or stenosis. Symptomatic, perianal fistulas should be surgically drained before anti-inflammatory therapy will be initiated. Antibiotics, such as metronidazole, improve disease symptomatic however, they are not sufficient to induce continuous fistula closure. For this purpose, azathioprine/6-mercaptopurine as well as anti-TNF antibodies are useful when administered continuously. Surgical options include seton drainage, fistula excision, fistula plugs and mucosa flaps. As ultima ratio, temporary ileostomy and proctectomy are to be discussed. Non-perianal fistulas often require surgical approaches. Symptomatic strictures or stenosis can be treated by anti-inflammatory medications (only if they are cause by inflammation), endoscopic balloon dilatation or surgery.

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Additional indexing

Other titles:Therapy of complicated Crohn's disease
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gastroenterology and Hepatology
Dewey Decimal Classification:610 Medicine & health
Language:German
Date:12 March 2014
Deposited On:11 Feb 2015 11:31
Last Modified:05 Apr 2016 18:49
Publisher:Hans Huber
ISSN:1661-8157
Additional Information:Diese Artikelfassung entspricht nicht vollständig dem in der Zeitschrift veröffentlichten Artikel. Dies ist nicht die Originalversion des Artikels und kann daher nicht zur Zitierung herangezogen werden.
Publisher DOI:https://doi.org/10.1024/1661-8157/a001592
PubMed ID:24618311
Permanent URL: https://doi.org/10.5167/uzh-105064

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