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Indications include: Medically refractory disease not responding to optimized biologic therapy Bowel obstruction from fibrostenotic stricture Intra-abdominal abscess not amenable to percutaneous drainage Complex perianal fistula (seton placement, diversion) Enterocutaneous or enterovesical fistula Dysplasia or cancer in Crohns colitis Free perforation (rare) Nutritional Therapy Exclusive enteral nutrition (EEN) effective for induction in pediatric Crohns

There are accounts of potential toxicity or side effects that are not yet fully mapped, and some researchers have voiced public concerns with both safety and efficacy

Once you find the dose that is not creating these problems, over time your body may adjust to it and you won't have such a strong reaction

Basically, closure of fistulas may be a measure of particular agents capacity to cure, at the same time, the skin wound and other corresponding tissues wound (Klicek et al., 2008