Other disorders, such as erythema nodosum and pyoderma gangrenosum, are a reaction to the bowel disease. Still others can arise from nutritional deficiencies or are side effects of medications. Finally, there are miscellaneous complications whose cause is not known. The following is a review of these conditions and their treatment. They occur mainly in Crohn's disease, and may be the first indication that IBD is present.
Fissures are tears in the skin lining the anal canal.
Fistulas are abnormal connections between two organs in the body. In IBD, they can form between the bowel and skin. Drug treatment is directed toward suppressing the inflammatory activity of the bowel, which predisposes patients to these problems. Treatments include the antibiotic metronidazole and the immunosuppressive agents prednisone and prednisolone, or 6-mercaptopurine. If medical therapy fails, surgical treatment may be needed to remove fistulas and the underlying diseased bowel.