Surgical repair and biological therapy for fecal incontinence in Crohn's disease involving both sphincter defects and complex fistulas

► Complex surgical procedures have traditionally been avoided in severe Crohn's disease. ► Infliximab could change expectations achievable with surgical treatment. ► Sphincter defects and fistulas can be simultaneously addressed in incontinence. ► Combined biological therapy and surgery improved the Wexner and solved incontinence. ► Benefits of sphincteroplasty with antiTNF were stable after 48 months.