Background:
The significance of the presence of rectal strictures in Crohn's disease has not been well studied. The aim of this study was to examine patients diagnosed with Crohn's disease associated with rectal strictures and to describe co-existing manifestations of perianal disease (abscesses, fistulae, or skin tags) and strictures located elsewhere in the colon or small intestine.
Methods:
A cohort of 70 Crohn's disease patients with rectal strictures were compared with controls without rectal strictures matched for age, gender, and duration of disease. Analysis was done to better elucidate the association of rectal strictures with location of disease and other perirectal complications.
Results:
The average age of both groups of our Crohn's disease patients was 54 years and the average duration of disease since diagnosis was 315 months for the patients and 314 months for the controls. 54% of patients were women and 46% were men. 61.4% of the study population had Crohn's colitis, whereas the remaining 38.6% of patients had ileo-colonic involvement. In contrast, the majority of the control population had ileo-colonic involvement (74.3%). Perirectal fistulae were present in 61% of patients with rectal strictures versus 34.3% of controls (p value Ο 0.001). Perirectal abscesses were present in 50% of rectal stricture patients vs. 17.1% of controls (p value Ο½ 0.001). Anal skin tags were observed in 23% of study patients vs. 15.7% of controls (p value Ο 0.275). 37% of patients with rectal strictures also had strictures more proximal in the colon as compared to 54% of controls (p value Ο 0.07). Only 10% of the study population had small bowel strictures vs. 55.7% of the controls (p value Ο½ 0.001).