Anal skin tags are typically asymptomatic and present problems only when they interfere with perianal hygiene (Fig. 5). They are more prominent with active intestinal disease. Approximately 25% resolve spontaneously, generally after remission of concomitant bowel disease. These tags should not be removed
Haemorrhoids are uncommon in patients with Crohn's disease. They usually become symptomatic when accompanied by diarrhoea. Conservative treatment must include control of bowel function, warm sitz-baths, and topical medications. Usually these non-invasive measures are successful. If symptoms persist, rubber-band ligation might be helpful. In rare cases, if symptoms are severe, and the rectum is spared from illness, selective surgical haemor-rhoidectomy may be successful .
Most surgeons believe that surgery should be avoided in the treatment of haemorrhoid diseases in Crohn's patients. In a publication, Jeffery et al  reported the results of 21 patients with Crohn's disease presenting with active haemorrhoids that were treated surgically. Postsurgical complications, including sepsis, strictures, fistulae and unhealed wounds, occurred in ten patients, and six patients ultimately required a proctectomy.
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