I’m Tom Currie a 5th year medical student. This summer I undertook a summer studentship with Mr. Tim Eglinton,
a colorectal surgeon at Christchurch Hospital and Senior Lecturer at the University of Otago, Christchurch. The
Studentship studied the impact of a modern medication on the treatment of perianal Crohn’s Disease.
Crohn’s disease is a form of inflammatory bowel disease (IBD) that can affect any part of the gut from the mouth
to the anus. It is over represented in Canterbury when compared to international rates. Approximately 1 in 3 of
these patients develops problems in and around the anus (bottom) including abscesses and fistulas (abnormal tracts
between the anus and the skin). Recently developed medicines known as anti-TNF-α antibodies have been used
with some success to treat these complications of IBD.
The aim of my studentship was to determine the outcomes of patients treated with these medicines in Canterbury since their introduction and in particular whether any particular patients were more likely to respond to these medicines than others.
Seventy-five patients qualified for the study and data was collected from patient notes. The main findings were that 73% responded to the anti-TNF-α therapy but only 20% healed completely. We couldn’t identify any definite factors predicting a successful outcome with this treatment. However, we did find that the patients that didn’t respond
to anti TNF-α therapy tended to have more severe disease and despite their drug therapy many of them still required frequent surgery.
Surgery for severe perianal Crohn’s disease can be major, debilitating and can require a permanent stoma. For this reason further research into optimising the current therapies in this disease is necessary.
This research will need to focus the optimal duration of therapy, its combination with other medical and surgical treatments and whether any blood or genetic markers will help predict response to these potent medicines.
On a personal note it was a great experience to undertake this research and I’m sure what I learned will hold me in good stead for research in the future. It was also highly beneficial to learn about a disease in depth that affects our community on such a significant scale. I would like to thank Warner and Patsy Mauger for their very generous
sponsorship through the Bowel and Liver Trust: this would not have been possible without their help.