Crohn’s Disease is a chronic inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract. One of its most uncomfortable and complex complications is the development of fistulas, especially perianal fistulas. These abnormal tracts or tunnels form between the intestine and another organ or the skin, often causing pain, infection, and a significant impact on a patient’s quality of life. As a leading specialist in treating complex and recurrent fistulas, Dr. Samrat Jankar at Kaizen Fistula Care Clinic, Pune has helped numerous Crohn’s patients navigate this difficult condition with modern, minimally invasive treatments and a multidisciplinary approach. In this blog, we will explore how Crohns disease leads to fistulas, the symptoms, the diagnosis, and the most effective management strategies available today.
Understanding the Link Between Crohn's Disease and Fistulas:
Fistulas happen in about 30-40% of patients with Crohn’s disease, most commonly forming around the anal region—referred to as perianal fistulas. In Crohn’s disease, inflammation penetrates deeply into the bowel wall, which can cause ulcers that develop into tunnels and connect the bowel to adjacent organs or skin.
Common types of fistulas in Crohns disease include:
- Perianal fistulas: Connecting the anal canal to the skin near the anus.
- Enteroenteric fistulas: Between two segments of the intestine.
- Enterocutaneous fistulas: Between the intestine and the skin.
- Enterovesical fistulas: Between the intestine and the bladder.
- Rectovaginal fistulas: Between the rectum and the vagina (especially in women).
Among these, perianal fistulas are the most frequent and the most difficult to manage due to constant contamination from stool and complex tract anatomy.
Why Are Fistulas in Crohn's Disease So Difficult to Manage?
Managing fistulas in Crohn’s disease is more complex than treating a regular anal fistula because:
- Ongoing inflammation delays healing and increases recurrence.
- Multiple fistula tracts may be present.
- Infection and abscess formation are common.
- The immune system is compromised, especially if the patient is on immunosuppressive therapy.
- Surgical interventions carry risks and must be done cautiously to prevent damage to continence.
Therefore, treatment must be individualized, combining medical, surgical, and supportive care to achieve the best outcomes.
Symptoms of Fistula in Crohn's Disease:
Fistulas may vary in presentation depending on their location. Common signs and symptoms include:
- Pain and swelling near the anus or other affected area
- Persistent drainage of pus, stool, or fluid from an external opening
- Fever or chills if infection or abscess forms
- Discomfort while sitting or during bowel movements
- Skin irritation and foul odor due to continuous discharge
- Recurrent perianal abscesses
- Incontinence (in severe cases with sphincter involvement)
Due to these symptoms, fistulas can significantly impair the patient’s daily life and mental health, making timely diagnosis and expert treatment essential.
Diagnosis at Kaizen Fistula Care Clinic:
At Kaizen Fistula Care Clinic, under the expert guidance of Dr. Samrat Jankar, a comprehensive diagnostic procedure is followed to accurately map and assess the fistula. Diagnostic methods may include:
- MRI Pelvis (with fistulogram): The gold standard for detecting fistula tracts.
- Endoscopic Ultrasound (EUS): Helpful in assessing rectal and perianal fistulas.
- CT Scan or MRI Enterography: For internal or complex enteric fistulas.
- Colonoscopy: To assess the extent of Crohn’s inflammation and identify active disease.
- Examination under anesthesia (EUA): To probe and map the tract more precisely, often combined with surgical planning.
Dr. Jankar believes in treating not just the fistula but the root cause – Crohn’s inflammation – with a multi-disciplinary strategy.
Treatment Options for Crohn's-Related Fistulas:
At Kaizen Fistula Care Clinic, Dr. Samrat Jankar uses the latest techniques tailored to each patient’s condition. The treatment strategy includes both medical management and surgical interventions.
Medical Therapy:
Controlling Crohn’s inflammation is the first step. Common medications include:
- Biologics (Infliximab, Adalimumab): These anti-TNF agents are highly effective in closing fistulas and controlling inflammation.
- Antibiotics: Such as metronidazole or ciprofloxacin for infection control.
- Immunosuppressants: Like azathioprine or methotrexate in selected cases.
These medicines ease inflammation, promote healing, and reduce recurrence.
Surgical and Minimally Invasive Procedures:
When medical therapy alone isn’t sufficient, surgery becomes essential. Dr. Jankar specializes in advanced, sphincter-saving procedures like:
- Seton placement: A thread is placed in the fistula tract to allow drainage and prevent abscess formation.
- LIFT (Ligation of Intersphincteric Fistula Tract): A safe option for transsphincteric fistulas with good healing rates.
- VAAFT (Video Assisted Anal Fistula Treatment): A minimally invasive approach that visualizes and cauterizes the tract internally.
- Fistula plug or glue: Biocompatible material used to close the tract, especially in patients where surgery is risky.
- Advancement flap surgery: For rectovaginal or complex fistulas when the internal opening needs to be sealed.
Lifestyle and Diet Modifications:
Managing Crohn’s disease effectively also involves lifestyle changes:
- Balanced Diet: Avoiding trigger foods, increasing fiber intake (as tolerated), and maintaining hydration.
- Stress Management: Stress can worsen inflammation.
- Regular Follow-ups: To monitor medication side effects and Crohn’s activity.
- Personal Hygiene: Particularly important for patients with perianal fistulas to avoid secondary infections.
Conclusion:
A fistula associated with Crohn’s disease can be physically and emotionally draining, but with the right approach and expert guidance, it is manageable. At Kaizen Fistula Care Clinic, Dr. Samrat Jankar combines modern surgical excellence with a compassionate, personalized touch to deliver effective, long-term relief to patients suffering from this challenging condition. Don’t suffer in silence.
If you or a loved one is dealing with Crohn ‘s-related fistulas, early consultation can prevent complications and enhance quality of life. Book an appointment with Dr. Samrat Jankar and take the first step toward healing.
Recent News
How to Identify the Early Signs
7th July 2025
Fistula in Crohn’s Disease: How to
27th June 2025
Why Does an Anal Abscess Often
17th June 2025
Complications of Untreated Anal Fistula: A
7th June 2025
Why Some Fistulas Don’t Heal with
29th May 2025
Why Does My Anal Fistula Keep
21st May 2025
How to Manage Pain and Discomfort
9th May 2025
Why Some People Are More Prone
30th April 2025
Can an Anal Fistula Heal on
16th April 2025