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Crohn’s disease: is there any link between anal and luminal phenotypes?

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Perianal Crohn’s disease (CD) encompasses a variety of lesion similar to luminal disease, which are usually not distinctly assessed. Links between luminal and perianal CD phenotype remains therefore underreported, and we aimed to describe both luminal and perianal phenotype and their relationships.

Methods

From January 2007, clinical data of all consecutive patients with CD seen in a referral center were prospectively recorded. Data recorded until October 2011 were extracted and reviewed for study proposal.

Results

A total of 282 patients (M/F, 108/174; aged 37.8 ± 16.2 years) were assessed that included 154 cases (54.6 %) with anal ulceration, 118 cases (41.8 %) with fistula, 49 cases (17.4 %) with stricture, and 94 cases without anal lesion (33.3 %). Anal ulcerations were associated with fistulas (N = 87/154) in more than half of patients (56.5 %) and were isolated in 55 patients (35.7 %). Most of strictures (94 %) were associated with other lesions (N = 46/49). Harvey-Bradshaw score was significantly higher in patients with ulcerations (p < 0.001) as compared to those with perianal fistulas (p = 0.15) or with anal strictures (p = 0.16). Proportions of complicated behavior (fistulizing or stricturing) of luminal CD were similar according to anal lesions: anal fistulas were not significantly associated to penetrating Montreal phenotype (N = 4/31 p = 0.13) as well as anal stricture and stricturing Montreal phenotype (N = 3/49, p = 0.53).

Conclusions

The phenotype of luminal disease does not link with the occurrence and the phenotype of perianal Crohn’s disease. Anal ulcerations denote a more severe disease on both luminal and perianal locations and should consequently be taking into account in physician decision-making.

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Acknowledgment

None.

Authors’ contributions

TW, GB, and LS were involved in the study design, interpretation, and analysis of data and edited the manuscript. TW performed the collection of data. LS performed the statistical analysis. All authors reviewed the paper and approved the final submitted draft.

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Authors and Affiliations

  1. Department of Hepato-Gastroenterology, University Hospital of Rennes, Service des Maladies de l’Appareil Digestif, CHU, Pontchaillou, 2 rue Henri le Guilloux, 35033 Rennes Cedex, France

    Timothée Wallenhorst, Charlène Brochard, Jean-François Bretagne, Guillaume Bouguen & Laurent Siproudhis

  2. INSERM U991, University of Rennes 1, Rennes, France

    Charlène Brochard, Jean-François Bretagne, Guillaume Bouguen & Laurent Siproudhis

  3. CIC1414 University Hospital of Rennes, Pontchaillou, France

    Charlène Brochard, Guillaume Bouguen & Laurent Siproudhis

Authors
  1. Timothée Wallenhorst
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  2. Charlène Brochard
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  3. Jean-François Bretagne
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  4. Guillaume Bouguen
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  5. Laurent Siproudhis
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Corresponding author

Correspondence to Timothée Wallenhorst.

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The authors declare that they have no competing interests.

Source of funding

JFB has received lecture fees from Abbott Laboratories, Ferring, and MSD Pharma.

GB has received lecture fees from Abbott Laboratories, Ferring, and MSD Pharma.

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This work did not receive any financial support.

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Wallenhorst, T., Brochard, C., Bretagne, JF. et al. Crohn’s disease: is there any link between anal and luminal phenotypes?. Int J Colorectal Dis 31, 307–311 (2016). https://doi.org/10.1007/s00384-015-2390-8

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  • DOI: https://doi.org/10.1007/s00384-015-2390-8

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