Use of topical metronidazole in the treatment of anorectal Crohn's disease.

Anorectal Crohn's disease is one of the most problematic and debilitating forms of Crohn's disease. Crohn's disease is a type of inflammatory bowel disease that usually affects the intestines but may occur anywhere in the gastrointestinal tract and is frequently refractory to medication, which may ultimately result in proctocolectomy and ileostomy surgeries. It is reported in 3% to 5% of Crohn's patients and is found in conjunction with colorectal or enteric disease in one-third to one-half of Crohn's disease patients. This article discusses the use of metronidazole 10% ointment for the treatment of anorectal Crohn's disease. Since metronidazole is not U.S. Food and Drug Administration approved for treating anorectal Crohn's disease, and there is no commercially available metronidazole 10% ointment, compounding pharmacists can play a role in providing this dosage form. This article discusses some of the common symptoms of Crohn's disease and the use of topical metronidazole to treat the disease.