Perianal fistulizing Crohn's disease : Current perspectives on diagnosis, monitoring and management with a focus on emerging therapies
© 2024. Indian Society of Gastroenterology..
Crohn's disease (CD), a chronic inflammatory bowel disorder, manifests in various phenotypes, with fistulizing perianal CD (CD-PAF) being one of its most severe phenotypes. Characterized by fistula formation and abscesses, CD-PAF impacts 17% to 34% of all CD cases and with a significantly deleterious impact on patient's quality of life, while increasing the risk for anorectal cancers. The pathogenesis involves a complex interplay of genetic, immunological and environmental factors, with cytokines such as tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) playing pivotal roles. Diagnostic protocols require a multi-disciplinary approach including colonoscopy, examination under anesthesia and magnetic resonance imaging. In terms of treatment, biologics alone often prove inadequate, making surgical interventions such as setons and fistula surgeries essential. Emerging therapies such as mesenchymal stem cells are under study. The South Asian context adds layers of complexity, including diagnostic ambiguities related to high tuberculosis prevalence, healthcare access limitations and cultural stigma toward perianal Crohn's disease and ostomy surgery. Effective management necessitates an integrated, multi-disciplinary approach, especially in resource-constrained settings. Despite advances, there remain significant gaps in understanding the disease's pathophysiology and a dearth of standardized outcome measures, underscoring the urgent need for comprehensive research.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
|---|---|
| Enthalten in: |
Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology - 43(2024), 1 vom: 03. Feb., Seite 48-63 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Devi, Jalpa [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Crohn’s disease |
|---|
| Anmerkungen: |
Date Completed 11.03.2024 Date Revised 11.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s12664-024-01524-2 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM367982552 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM367982552 | ||
| 003 | DE-627 | ||
| 005 | 20240311232221.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240204s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s12664-024-01524-2 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1323.xml |
| 035 | |a (DE-627)NLM367982552 | ||
| 035 | |a (NLM)38308773 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Devi, Jalpa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Perianal fistulizing Crohn's disease |b Current perspectives on diagnosis, monitoring and management with a focus on emerging therapies |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 11.03.2024 | ||
| 500 | |a Date Revised 11.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. Indian Society of Gastroenterology. | ||
| 520 | |a Crohn's disease (CD), a chronic inflammatory bowel disorder, manifests in various phenotypes, with fistulizing perianal CD (CD-PAF) being one of its most severe phenotypes. Characterized by fistula formation and abscesses, CD-PAF impacts 17% to 34% of all CD cases and with a significantly deleterious impact on patient's quality of life, while increasing the risk for anorectal cancers. The pathogenesis involves a complex interplay of genetic, immunological and environmental factors, with cytokines such as tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) playing pivotal roles. Diagnostic protocols require a multi-disciplinary approach including colonoscopy, examination under anesthesia and magnetic resonance imaging. In terms of treatment, biologics alone often prove inadequate, making surgical interventions such as setons and fistula surgeries essential. Emerging therapies such as mesenchymal stem cells are under study. The South Asian context adds layers of complexity, including diagnostic ambiguities related to high tuberculosis prevalence, healthcare access limitations and cultural stigma toward perianal Crohn's disease and ostomy surgery. Effective management necessitates an integrated, multi-disciplinary approach, especially in resource-constrained settings. Despite advances, there remain significant gaps in understanding the disease's pathophysiology and a dearth of standardized outcome measures, underscoring the urgent need for comprehensive research | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Crohn’s disease | |
| 650 | 4 | |a Magnetic resonance imaging | |
| 650 | 4 | |a Perianal fistula | |
| 650 | 4 | |a Treatment outcome | |
| 650 | 4 | |a Tumor necrosis factor inhibitors | |
| 650 | 7 | |a Tumor Necrosis Factor-alpha |2 NLM | |
| 650 | 7 | |a Cytokines |2 NLM | |
| 700 | 1 | |a Ballard, David H |e verfasserin |4 aut | |
| 700 | 1 | |a Aswani-Omprakash, Tina |e verfasserin |4 aut | |
| 700 | 1 | |a Parian, Alyssa M |e verfasserin |4 aut | |
| 700 | 1 | |a Deepak, Parakkal |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology |d 1993 |g 43(2024), 1 vom: 03. Feb., Seite 48-63 |w (DE-627)NLM012713031 |x 0975-0711 |7 nnns |
| 773 | 1 | 8 | |g volume:43 |g year:2024 |g number:1 |g day:03 |g month:02 |g pages:48-63 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s12664-024-01524-2 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 43 |j 2024 |e 1 |b 03 |c 02 |h 48-63 | ||