The presence of fistulizing Crohn’s disease (FCD) reflects a distinct, aggressive phenotype of CD and indicates a challenging and complicated disease course necessitating an early, intense, and multidisciplinary approach to treatment. Compared with patients without perianal involvement, patients with perianal FCD have higher rates of hospitalization, surgery, and use of immunosuppressive medications and are at higher risk of complications, including anal and rectal cancer. Further, despite...