Perianal Crohn’s disease is a complication of Crohn’s disease that manifests with inflammation around the anus. Symptoms may include pain, swelling, bleeding, ulcers, and fecal incontinence. Treatment is available and can help improve quality of life.

Crohn’s disease can affect different parts of the gastrointestinal tract, including the anus. Perianal means around or near the anus.

Not everyone with Crohn’s disease will experience localized symptoms in the anus, but those who do may have a higher need for hospitalization and surgery.

If you have perianal Crohn’s disease, you may experience common Crohn’s disease symptoms. These symptoms may improve for some time and then reappear.

In addition, if you live with perianal Crohn’s disease, you may also have:

  • anal bleeding
  • anal pain
  • anal itching
  • mucus or pus-like discharge coming from the anus
  • increased bowel urgency
  • bowel incontinence

Perianal Crohn’s disease may lead to other characteristic symptoms over time, including:

  • Abscesses: An abscess is a small pocket filled with pus from a bacterial infection.
  • Ulcers: An ulcer is an open sore.
  • Skin tags: A tag is a small skin growth.
  • Fissures: An anal fissure is a tear in the lining (outer layer) of the anal canal.
  • Fistulas: A fistula is an abnormal tunnel that forms between one organ and another.
  • Rectal strictures: A stricture happens when scar tissue from chronic inflammation partially or fully blocks the rectal or anal opening. Strictures often require surgery.

Some people with Crohn’s disease, including perianal symptoms, may also experience symptoms of depression and anxiety.

A gastroenterologist can help you with diagnosis and treatment. They may want to start by discussing your medical history, your family medical history, and your past and current symptoms.

Questions and discussion points during the first consultation may include:

  • How long have your symptoms lasted?
  • Have you noticed any blood in your stool?
  • Do you have any persistent diarrhea or vomiting?
  • How’s your appetite?
  • Have you experienced unwanted weight loss?
  • Do you have any stomach swelling?
  • Do you have any type of stomach pain?
  • Have you ever had any persistent anal pain or itching?
  • Have you experienced any bowel incontinence?
  • What are some of your past digestive concerns?

If you already have a Crohn’s disease diagnosis, the doctor will likely want to look at the imaging and other tests you had during that process. They’ll then want to perform a physical examination.

For perianal Crohn’s disease, the doctor will check the anal area for inflammation, ulcers, skin tags, and signs of fistulas or fissures. The presence of these physical symptoms, along with your reported symptoms, may confirm a perianal Crohn’s diagnosis.

You may also need imaging tests of your digestive tract, such as:

  • CT scan
  • pelvic MRI
  • endoscopy
  • colonoscopy

Perianal Crohn’s disease requires a multidisciplinary team approach. The exact treatments will depend on the severity of your symptoms, overall physical health, and doctor’s recommendations.

A healthcare team may recommend managing perianal Crohn’s disease with the following:

  • Antibiotics: These short-term medications may be used to treat abscesses and to ease inflammation.
  • Immunosuppressive medications: These are a long-term option for reducing inflammation and can help with overall symptoms of perianal Crohn’s disease.
  • Biologic medications: Biologic drugs for Crohn’s disease are medications made from living cells that help reduce inflammation. They are usually part of Crohn’s disease treatment and will help resolve symptoms of perianal Crohn’s.
  • Surgery: Surgeons can close fistulas and remove strictures, abscesses, and other inflamed tissue.
  • Lifestyle changes: Some changes to your diet may make digestion easier and reduce some symptoms of perianal Crohn’s. Stress management is also recommended.

Although there’s no cure for any type of Crohn’s disease yet, treatment may help ease symptoms and improve outcomes.

Severe cases of perianal Crohn’s disease are associated with a higher need for hospitalizations and surgery, though. Colon cancer and medication dependency are also more prevalent among people with perianal Crohn’s disease.

Adhering to the management plan as much as you can, including lifestyle changes, may help decrease discomfort and improve some of your symptoms.

Seeking support from trusted friends, Crohn’s disease groups, and mental health professionals may also help you cope with the challenges of having perianal Crohn’s disease.

Perianal Crohn’s disease affects your gastrointestinal system and causes localized symptoms around your anus. These symptoms may include pain, itching, skin tags, ulcers, and fistulas.

Perianal Crohn’s may involve increased challenges. People with this type of Crohn’s may need frequent hospitalizations and surgery. Treatment improves symptoms and may put the condition into remission.

Adhering to the treatment plan, requesting help from friends and family, and seeking out support groups and mental health care may help you cope.