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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

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These additives can affect the pH and osmolality of the solution, which influences injection site comfort