Tratamiento de la enfermedad de Crohn perianal Treatment of perianal Crohn's disease

Perianal affectation due to Crohn's disease includes a wide spectrum of lesions involving different management and prognosis. A thorough exploration of the patient, under anaesthetic if necessary, a recto- scope to evaluate the possible affectation of the rec- tum by the disease, and on occasions evaluation through endoanal echography or magnetic resonance, are the bases for a correct diagnostic and therapeutic focus. Pharmacology and surgery must be comple- mentary in the treatment of perianal Crohn's disease and must pursue a double aim: to alleviate the symp- tomology of the patient and prevent possible compli- cations. Except in situations of emergency due to peri- anal sepsis, medical treatment is the first step in man- aging perianal Crohn's disease, and on many occasions it will control the disease, making surgery unneces- sary. When surgery is required, with the aim of a defin- itive treatment of the perianal lesion, the risk of devel- oping complications, especially incontinence, must be contrasted.