Perianal Crohn's disease: Current perspectives and a tertiary centre experience

Perianal fistulising Crohn's disease (PFCD) is a debilitating phenotype of Crohn's disease (CD), with a lifetime incidence of 20–30% in people living with CD. Symptoms include perianal pain, perianal discharge and faecal incontinence, with repercussions for physical and mental health, psychosocial wellbeing and productivity. PFCD is challenging to treat, with existing therapeutic options only achieving modest fistula remission rates. While research initiatives are underway to characterise PFCD pathogenesis and optimal treatment approaches, the focus should be on early diagnosis and prompt management. This can be achieved with patient education, effective coordination of care within the multidisciplinary team and an accessible inflammatory bowel disease (IBD) service. IBD specialist nurses may be the first healthcare professionals to encounter a patient with a new diagnosis of PFCD or its complications. This review article summarises the existing evidence relating to clinical aspects of PFCD from a multiprofessional perspective and discusses the role of a dedicated IBD surgical link nurse in PFCD management in a tertiary centre setting.