The incidence and course of perianal complications and arthralgia after intestinal resection with restoration of continuity for Crohn's disease

Abstract

Summary The influence of bowel resection for Crohn's disease on the frequency of arthralgia and perianal manifestations was evaluated in a follow-up study of 82 patients. Arthralgia and perianal manifestations were analysed according to two separate periods: the preoperative duration of disease (4·2±3·2 years) and the postoperative duration (4·3±2·6 years). In patients operated on more than once, the time before the first and after the latest operation was included in the study. At the time of the follow-up, 19 patients suffered from recurrent disease. The frequency of arthralgia did not change after resection irrespective of whether or not there was recurrence. In patients without recurrence, however, perianal manifestations diminished after resection (P < 0·05). In the postoperative period only 10 per cent of those without recurrence suffered from perianal lesions compared with 47 per cent of those with recurrence (P < 0·001). If perianal lesions were in existence preoperatively, they healed spontaneously in 80 per cent of the patients without recurrence, but were still active among those with recurrence (P < 0·001). Our results indicate that the perianal manifestations are closely connected to the inflammatory process in the intestine. On the other hand, the arthralgia seems to be independent of the inflammatory process of the bowel and may be related to a general defect of the gastrointestinal mucosa in Crohn's disease.