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Colorectal Diseases

Perianal fistulas

02/20/2008

Question:

Will two perianal fistulas due to Crohn`s disease ever stop draining and close completely?

Drainage is still thick and greenish-yellow. Anal setons X 2 have been in place for 2 months and am on 100 mg of Imuran daily for 2 months. What more either surgically or medically can be done to get these to close already?

Answer:

They can close, occasionally, with medical therapy. The purpose of the Seton is to prevent infection from accumulating under the skin, in the tract. As long as the Seton is in place, you should not develop infection at that site; the Seton is stenting both the skin and the internal opening "open".

Consider a consult with a colon and rectal surgeon, who can examine your rectum and determine if the inflammation is responding to your Imuran. If so, there may be a surgical procedure to promote closure of the fistula.

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati