Crohn's Disease Anal Disease Background
Perianal Complications

Crohn's Disease Fistula·Fissure·Abscess
Healing without surgery

Frequent recurrence and wounds that do not heal even after surgery, HanStep treatment is the answer.

Statistics & Facts

The first sign of Crohn's disease,
Anal lesions

Perianal lesions can be the first sign that occurs more than 6 months before diagnosis in approximately 17.2% of all Crohn's disease patients. It is reported that fistula occurs in 10-26% of Crohn's disease patients worldwide, and compared to simple fistulas, complex fistulas are more difficult to treat and have a lower probability of Crohn's disease remission.

Cumulative Incidence of Perianal Disease

Within 1 year
12%
Within 5 years
15%
Within 10 years
21%
Within 20 years
26%

* The prevalence of fistula varies depending on the location of the disease: 12% for ileal disease alone, 15% for ileocolonic disease, 41% for colonic disease, and it is most severe at 92% when the rectum is involved.

Anal illustration
Risk of recurrence after treatment
The probability of recurrence within 18 months after perianal disease in Crohn's patients is treated reaches 44%.
Major Complications

Major anal complications

Crohn's disease causes various complications such as fistula, fissure, and anal abscess as the mucosa of the rectum and anal canal ulcerate due to chronic inflammation.

Fistula

Fistula (Perianal Fistula)

A condition where an abnormal fistula is formed between the inner side of the intestine and the skin around the anus and rectum.

Clinical symptoms
  • Pain, swelling, purulent pus, and discharge
  • Abscess formation and recurrent infection
  • Skin irritation around the anus and worsening pain
  • Lower quality of life due to pain and bleeding after defecation
Fissure

Fissure (Anal Fissure)

A condition where the perianal mucosa is torn, causing pain and bleeding. In Crohn's patients, it often occurs in atypical locations or becomes chronic.

Clinical symptoms
  • Severe pain and bleeding during defecation
  • Accompanied by skin tags or scar lesions when chronic
  • Conservative treatment is recommended first.
Anal Abscess

Anal Abscess

A lesion with localized pus in the soft tissue space around the anus or rectum. It is more frequent than in the general population and carries a very high risk of progression to anal fistula.

Clinical symptoms
  • Severe perianal pain (worsened when sitting or defecating) and tenderness
  • Local swelling, redness, fever, and difficulty defecating
  • Systemic fever, chills, fatigue, and elevated inflammatory markers
  • Immediate drainage is recommended.

"If the wound does not heal even after surgery,
you need to change the direction of treatment."

It is common for incisions not to heal for months to years after Crohn's disease fistula surgery.

Therapeutic Approaches

Limitations of conventional treatment and HanStep solution

Western medical treatment

  • Medical treatment (ACG/AGA recommended)
    • The use of biological agents such as Infliximab (Remicade, Remsima, etc.) (anti-TNFα) is strongly recommended for induction and maintenance treatment.
    • Combined use of antibiotics (metronidazole, ciprofloxacin, etc.) is sometimes recommended, but the effect is limited. Although most commonly used, there is little evidence for efficacy.
  • Surgical treatment
    • If an abscess is present, surgical drainage is necessary.
    • Seton placement: Long-term maintenance of a seton string for drainage is recommended. It prevents early closure of the fistula and prevents recurrence, but this method itself is not a fundamental treatment for fistula.
    • Fistulotomy: A procedure to open the fistula tract, which can be chosen when sphincter involvement is less, but there is a risk of incontinence after surgery.

Problems with Crohn's disease fistula surgery: The recurrence rate is high, surgery is not easy in cases of complex fistula, and the risk of infection is high. Complications during recovery (delayed wound healing after surgery), risk of fecal incontinence, etc. occur. In particular, in the case of Crohn's fistula, fissure, and abscess, it is a very common and serious problem that the incision 'does not heal' for months to years after removing inflammation with surgical methods.

HanStep Korean Medicine Clinic treatment

Depending on the size of the abscess and the condition of the fistula, surgical procedures may be required. However, it is common for wounds to remain unhealed for years after abscess incision or seton placement for fistula, and in such cases, symptoms can be improved through herbal acupuncture treatment 1-2 times a week.

  • Herbal acupuncture treatment

    Made by refining herbal medicine, it contains no chemical drug ingredients and is a great help in recovering stalled wounds and eliminating inflammation.

  • Integrative approach

    It is especially helpful when surgical procedures have already been performed in Western medicine for fistula, fissure, abscess, etc., but they have not recovered. We help the body itself overcome inflammation and heal the wound.

Treatment period and prognosis:

  • For fissure, abscess, and unhealed wounds, we aim for recovery within 3~6 months.
  • If the fistula is deep or complex, and depending on the patient's condition and lifestyle, a treatment period of 1 year or more may be required.
Non-Surgical Care

Unhealed wounds,
with the power of fundamental regeneration

Are you suffering from being in a stalemate after abscess incision and seton placement?
HanStep treatment wakes up stalled tissue regeneration
and helps you return to a comfortable daily life without surgery.

F.A.Q

Frequently Asked Questions

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