30th July 2023

A 40-year-old man with a background of Crohn’s disease presents to the medical day case unit with rectal pain and perianal drainage

A 40-year-old man with a background of Crohn’s disease presents to the medical day case unit with rectal pain and perianal drainage. He denies any fever, chills or malaise. On inspection of the perianal skin, a cutaneous fistula confined to the anal canal is observed, with visible discharge. Palpation of the perianal skin does not reveal any obvious masses or significant tenderness. A digital rectal examination is performed – no perianal erythema was observed and no mass or nodule was palpable.

Given the aforementioned clinical features, what is the next stage of management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.