About the Perianal IBD Program

The Perianal IBD Program is the first of its kind to bring together a team of specialists – from pediatric gastroenterology, surgery, wound care, pelvic floor, physical therapy and psychology – dedicated to advancing and transforming care for pediatric patients with perianal inflammatory bowel disease (IBD). The new initiative at Children’s Hospital of Philadelphia (CHOP) is a partnership of the Center for Pediatric Inflammatory Bowel Disease (IBD) and CHOP’s Center for Microbial Medicine, the leading pediatric center in the United States focused on microbiome-informed clinical care.

Following a thorough evaluation, each child will receive an individualized, comprehensive treatment plan, including a discussion of their eligibility for state-of-the-art therapies available at CHOP. The primary goals of the Perianal IBD Program are to deliver world-class, comprehensive care to pediatric patients with perianal IBD and to collaborate with other experts to advance the science and technologies for treating perianal complications.  

About perianal IBD

Perianal IBD occurs in about 20-25% of children who have Crohn’s disease. Perianal features of Crohn’s disease may include a fistula, abscess, fissure, stricture or other damage to the anus and surrounding tissues. Given the wide-ranging presentations and clinical courses, there are likely genetic, epigenetic, microbiome, and other environmental factors that collectively influence perianal IBD. Perianal disease may persist despite medical and surgical interventions and can cause a significantly reduced quality of life in children. 

Evaluation and treatment

After a thorough review of medical records, patients will be evaluated by members of the Perianal IBD Program team for assessment. If it is determined that additional imaging and/or procedures are needed to further assess and manage the perianal disease, these can be arranged with CHOP’s radiology, gastroenterology, and surgery teams. Testing may include an MRI, examination under anesthesia, endoscopy, endoscopic ultrasound and/or specialized wound care. The type and sequence of these pre-treatment tests and interventions will depend on the patient’s history, presentation and symptoms.

The primary goals in managing perianal IBD are to reduce symptoms, enhance tissue healing and improve the patient’s quality of life. Treatment strategies vary depending on the type and severity of the patient’s perianal features but typically require a multidisciplinary approach. The perianal IBD team will craft a personalized plan, which may include unique treatment options only available at CHOP, should they be a candidate for care. 

A unique treatment option for patients with perianal disease that is available through CHOP in collaboration with the Hospital of the University of Pennsylvania is hyperbaric oxygen therapy (HBOT). The goal of HBOT is to heal soft tissues by increasing the body’s stem cells in damaged areas of the body. HBOT is used for many types of medical issues, including wound healing, and has shown success in healing some forms of perianal disease. This rare treatment strategy may be used to supplement a patient’s primary care management for perianal IBD. 

Another rare treatment available at CHOP for persistent perianal fistula is stem cell injection therapy. This is done by injecting stem cells into and around the perianal fistula to help with healing. This therapy is currently part of a clinical trial at CHOP for patients age 18 or older and may be used to supplement a patient’s primary disease management plan.

Follow-up care

Any patient treated for perianal IBD at CHOP can continue care here to assist with managing their disease. Depending on how many different specialists the patient needs, they may be seen within the multidisciplinary Perianal IBD Program or may see certain specialists individually. 

How to refer

To refer a patient for evaluation with the Perianal IBD Program at CHOP, please contact the Center for Pediatric IBD by phone, email or online submission form. 

Phone: 215-590-7423 | Email: ibdcenter@chop.edu | Complete our online submission form.