Abscess healing without surgery..Did I get lucky?

[KWalker]

Please only help if you have experience. If you've read any of my other posts lately I had another abscess forming which I thought was going to require surgery for was actually booked with the surgeon to have surgery today. Back in the middle of last week the abscess popped and was continually draining pretty heavily for the last few days and with cipro and flagyl on top of the draining, it has gone quite down in size and the pain is now almost non-existent.

When I've been in contact with my surgeon she said there's no point in doing surgery and going through all of that if it is open and draining and just to keep an eye on it and give her a call here and there to give updates or if needed. Do you think since it's popped and now draining that I won't need the surgery?

I know there's some threads about the topic before but they're old and I didn't want to bring back a dead thread from awhile back and with new people always browsing the forums you never know what new info could come out.

Thanks guys. I'm really hoping to not need the surgery but if it's just going to close up and keep filling up and popping then I'd rather just get it over with now.

 

[Aussie]

Hi KWalker, can't imagine the fistula will heal by itself, although surgery is useful for drainage and seton insertion, biologic therapy would be the best. Why did you stop infliximab and humira, any chance of returning to either of those to help close the fistula.

 

[KWalker]

I don't have a fistula...



Also, if you give a response could you please say why with your answer? The surgeon said that it popping on it's own is essentially the same thing as if she were to go in and cut it. They both just promote draining so basically it's opening on it's own it doing exactly what she would do if it didn't.

 

[Aussie]

Unfortunately, with Crohn's, almost all perianal abscesses ultimately lead to fistula formation, which may have already happened. MRI of the anorectal region is a great way to get a roadmap of the abscess, along with any connections of the abscess to the bowel.

The surgeon is correct, to a degree. While the abscess has an open connection that can drain, then she won't need to drain it. However, if a seton was inserted, then at least the drainage is guaranteed, unlike letting it drain by itself. The difficulty here though is that you need something to try to heal the abscess/fistula, antibiotics are helpful, but the problem usually recurs when you stop them. Thiopurines are disappointing in regards to fistulising perianal disease. The best, by a significant margin, would be biologic therapy - you've stopped infliximab and humira, any chance of reintroducing them, if not, perhaps cimzia might be worth a look.

 

[KWalker]

I've had the tests, and my abscesses before have not turned into a fistula either. I'm not trying to come off as rude so please don't take it that way I just think it's pointless to worry about something I don't have right now.

Back in late 2011 I had what would probably be the worst abscess any member of crohnsforum has ever had and it blew any other out of the water in size and even that did not turn into a fistula. I'm just wondering about the abscess right now.

 

[KWalker]

and to answer your question about stopping the Remicade and Humira, I was on both of them and stopped them before I even developed my first abscess. I took each medication in my signature alone and went from med to med as they stopped working after awhile and lost effect for me. I was on Remicade and it stopped working so they stopped and tried Humira which also stopped working. They are both expensive and although I can get help for them, they're not at the top of my list of medicine I want to go on right now.

 

[Mom2oneboy]

Hi KWalker,

Sorry to hear that you are dealing with another annoying abscess. Glad to hear that it's draining on its own though.

My son had one last December that had to be drained by a surgeon. It came back again in February and drained on its own so the doc said there was no need for surgical intervention. It has gotten sort of a pimple head on it several times and 2 warm baths a day for a couple of days and it drains. His GI said it may be a window into what's going on intestine wise for him. We haven't been able to get him into remission since his diagnosis in February. He's just had his second dose of Remicade so we're hopeful it will be gone for good.

Hope yours heals and no surgery is necessary!!

 

[KWalker]

Thanks Mom2oneboy and I'm sorry you guys aren't having luck getting your son into remission. I've also had surgery for a different abscess but comparing the two...well there really is no comparison at all. Does your son usually have a lot of discomfort during those periods when it does come to a head and pop? and has your doctor said anything about eventually going back and doing the surgery or to leave it as long as you can deal with the occasional draining?

If you guys are having problems with draining and ruining underwear/pants it's not a bad idea for him to wear female pads. I know no guy wants to wear them but I'm a 22 year old guy and I have to wear them now with drainage and I did back when I had the last surgery as well. To me it's much better than getting up after class and having a wet mark on your pants.

Seeing that you guys are fairly new with the diagnosis I'm sure you'll find remission (if not close too) soon especially starting with Remicade that soon. I wish I had Remicade back at diagnosis. Thank you for your help

 

[Mom2oneboy]

The doctor hasn't mentioned anything about surgery. His thinking is that if we get the disease under control the abscess will go away. I sure hope he's right about that! As far as the pain goes, the first one was very painful and he couldn't even sit comfortably on his bottom. When it came back in Feb. and popped on it's own it was more of a discomfort. He didn't require any pain meds. It drained for 2 days and then stopped.

I do a "butt check" on him every night after he bathes. If it starts getting a head on it I'll give it a couple of days to pop on it's own and if it doesn't I get one of his MTX injection needles and pop it. His doc is fully aware of me doing this and has actually done it too. I would NOT do this if it's not near the surface (like his first abscess). His looks like a pimple....I can actually see the white stuff with just a very thin layer of skin over it. I have probably just given you way more information than you wanted....LOL.

We did have to use female pads after surgery. The good thing was he had NO idea what the pads are supposed to be used for . Thanks for the kind words. I hope remission pays us a visit real soon. I think we are headed in the right direction!

I hope your abscess is better!! Do baths help it feel better? Hang in there!

 

[KWalker]

Lol I think I'll just skip dinner tonight. Haha just kidding its not that bad, just the thought of that makes mine hurt lol. Like your son, mine is more of a discomfort now and its very minimal at that, as it continues to drain and go down in size. Because it doesn't give me pain anymore, I only use the bath to help continue drainage but I find a heat bag is easier because its hard for me to squeeze a 30 minute bath into my schedule right now with school. Back when it was really hurting, and I mean I could barely walk, I couldn't sleep, sit or do much of anything, I was often in the bath even through the middle of the night because it was the only time I had relief and then the second I got out, the pain came back.. So thankfully were past that now.

 

[Mom2oneboy]

Glad you are better! If you find that it needs to be popped, come on over . I've got skills :ylol:.

 

[KWalker]

LOL, I'll just have to think about you popping it with that needle and it will scare the pus right out of it!

 

[ontariomom]

without going into my long story, last march my abscess ruptured on its on. A large abscesss. It was so painful the weeks leading up to it that i couldnt move or sit or lay.....it was horrible. When it ruptured i was so friggin happy. I could move without the pain.

many many antibiotics, it built up a little he drained it, and about 1- 2 month later my surgeon told me it was healing well. I felt amazing. He did warn me that a fistula was possible. Well, a few weeks after that appt....i felt that familiar pain. So bad my whole body was shaking. Sitz baths, heat bags , tylenol and motrin(before i knew it was crohns) and i still wouldnt get relief. Finally it popped again. Only this time he took me into the OR to check it out and it was a fistuala, in went a seton and well....that was over a year ago.
So i think it can heal. Mine did. Then mine became a fistuala. So? I guess nothing is guaranteed. Hopefully you do better then i did.