Anal fistula with seton

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Joined
Apr 6, 2014
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Hello,

I am new to this forum and am just looking for some advice.
I have not been diagnosed with Crohn's disease, but I have now had two fistulas. My first was in 2011, and it healed very well after a fistulotomy. My second started causing issues around November of 2012. Initially an abscess would fill, be lanced and drained, and this happened about once a month for 4 months. Eventually a surgeon cut out the abscess, which never healed, so a seton was put in.

This seton caused major discomfort, and my surgeon thought that a secondary abscess had formed. It turns out I just had some sensitivity to the seton. I eventually had a LIFT procedure done in February, which failed and I now have another seton, as well as a (now mostly healed) large hole from where an abscess was cut out.This seton is much more painful than the first. The pain extends all the way up to my tailbone, and there is so much discomfort when I sit, stand, walk, or do anything really. It's been about two weeks.

I know this is because the seton is probably causing some annoyance to the muscles in the anal area, but does anybody have any suggestions for easing this pain? Would it just take more than 2 weeks for the seton to really get "comfortable" or easier to deal with?
 
It's still really early but do a lot of warm sitz baths and I also find sitting on a heating pad was helpful. If it continues, you can see if the surgeon can put in a smaller or different type of seton that may be more manageable.
 
Thank you for the suggestion.

I have been having a lot of sitz baths but have been using ice packs (the nurse at the hospital suggested) more than heating pads. I'll give the heating pad a try.
 
Interesting never tried the ice when I had setons. I also found a donut hole like cushion at the drug store. Not sure what else to call it but it was by where they sell sitz basins and id use it to sit sometimes without putting pressure on the seton.
 
My first seton was extremely u comfortable (it was the silk seton) and I still had pain 6 weeks after so the surgeon changed it to a rubber seton which causes less irritation. Pain still continued, and 4 surgeries later I actually needed 3 setons and now I am pain free. So maybe you need a diff kind of seton, or maybe you have more then one fistula/abscess that they didn't see the first time. Or maybe you just need more time. The surgeon says if after 6 weeks there is still pain, most likely something is wrong
 

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