Abstract
Perianal fistulising Crohn's disease (PFCD), a chronic debilitating condition affecting a third of patients with CD, carries substantial associated morbidity and negatively impacts quality of life (QoL). The three basic tenets of PFCD management have been to drain sepsis, control inflammation and heal the fistula, if appropriate. The caveat is attached to the third tenet because not all Crohn's fistulas are suitable for curative treatment; the principal focus of management is QoL, driven by the patient's expectations, as formally recognised in the recent comprehensive classification of PFCD.