Concerns post Seton Placement!

[ManwithSeton]

HI All,

My first post so play nice please :ysmile:

Been 2 weeks since the seton placement surgery. The pain is just about manageable now. I was off work for nearly 10 days as the pain was unbearable post surgery. I am due to be seen in the clinic in 8 weeks time for a follow up.

Along with the pain, my 2nd biggest worry is that since the operation, the abscess/puss discharge quantity has increased quite a lot. Prior to surgery, I used to place toilet tissue to absorb the fluid which i only replaced at the end of the day. Since the surgery however I am having to replace the paper 3 to 4 times a day. Also, I have noticed that the smell is unbearable of abscess/puss. Is it normal?

Please advise.

 

[Madhu]

Hello

Sorry you had to join this forum. Have you been diagnosed with Crohn's. I see you have a seton placed, so it must be for a fistula. How many do you have? Hopefully just one My husband has 2 setons inside for 2 fistulas and he had a lot of drainage too. I don't think toilet paper will help much since some days it will be more and some days nil and toilet paper may not absorb it properly. My husband used surgical gauze pads which you can get at any pharmacy. He always wore it whether he had drainage or not. I am not sure about the smell but I'm pretty sure the drainage quantity increase is good. That is the purpose of placing a seton. It is like a rubber band holding both ends of your fistula and keeping it open so that infection (pus and blood) drains out. It should drain out, only then they can start you on your medication. Hope it helps

 

[Robrich]

Gauze replaced several times day. Sitz baths or hot compresses help draw out the puss.
I take antibiotics as well, augmentin but Flagyl, cipro is preferred if you can tolerate them.
Diet helps as can bone broths. Takes time. Have had mine for a year now and next week I will be. Seeing my GI about removing it.
No discharge for 2 mos.
Good luck

 

[paul11]

The best thing for it is gauze that comes in rolls that you cut off yourself and make pieces the size that you need. Just do a bunch at a time. You can buy it in bulk online for pretty cheap. Hope this helps. I've had two setons done as well. Both out finally but one fistula hasn't healed over totally so I still use the gauze because some of the "stuff" when I go to the bathroom eventually goes down the wrong way and out the fistula. Anyways, that type of gauze I find is the easiest to use and replace frequently.

 

[ManwithSeton]

Hi All, thanks for replies.

I have not been diagnosed with crohn's disease, I just needed a forum where I could share and get some support for fistula.

I only have one in place. The outer opening is around an inch away from anus hole and the inner opening is inside half an inch up the anus. Had it for a hear, waited 9 months on waiting list for the seton placement.

I have not been given any medication but will be seen in 8 weeks (from the date of surgery). I have noticed the drainage has slowed a little bit.

What would happen after 8 weeks. Is seton going to close the track or a further surgery will be needed to cure this?

 

[kelly1]

Hi
The seton will just keep the fistula draining. When you see your surgeon they will discuss a repair surgery for the fistula or if you are happy to you can keep the seton in.
I had a repair surgery for my fistula 8 weeks ago and am having surgery on Thursday again. These fistulas are not nice things to treat.

 

[ManwithSeton]

I do remember in the initial consultation he said it may take multiple surgeries to repair or may be few. Looks like I am in it for a long ride.

I also had 2 surgeries on haemmorhoids. Is there any relation in the 2? Can one make the other worse. My piles are under control thank God but that's another thing which never goes away :confused2:

 

[Worrywart]

Hi All, thanks for replies.

I have not been diagnosed with crohn's disease, I just needed a forum where I could share and get some support for fistula.

I only have one in place. The outer opening is around an inch away from anus hole and the inner opening is inside half an inch up the anus. Had it for a hear, waited 9 months on waiting list for the seton placement.

I have not been given any medication but will be seen in 8 weeks (from the date of surgery). I have noticed the drainage has slowed a little bit.

What would happen after 8 weeks. Is seton going to close the track or a further surgery will be needed to cure this?

Hi - I too have a non Crohn's fistula - mine was as the result of surgery when my bowel ruptured. Long story. I have had mine 8 months now and no sign of healing - mine is in my abdomen. I suppose it depends what caused the fistula as some do heal spontaneously. The seton is just put in to keep the tract open to prevent the infection building up inside which would make you Ill. Do you have any form of bowel disease that caused the fistula?

 

[ManwithSeton]

Hi - I too have a non Crohn's fistula - mine was as the result of surgery when my bowel ruptured. Long story. I have had mine 8 months now and no sign of healing - mine is in my abdomen. I suppose it depends what caused the fistula as some do heal spontaneously. The seton is just put in to keep the tract open to prevent the infection building up inside which would make you Ill. Do you have any form of bowel disease that caused the fistula?

I haven't been diagnosed with bowel disease. the only surgeries I had was on piles twice prior to fistula which started around a year ago.

 

[kelly1]

You may well be in it for the long ride, I have had mine for 2 years and 3 months and am having number 15 surgery this week.
I wouldn't of thought that the 2 conditions would make things worse but id check with your surgeon.
Have they discussed any repair surgergies with you?

 

[ManwithSeton]

Have they discussed any repair surgergies with you?

No. Actually I have been pretty disappointed with the way the whole thing has gone. I was told if during the surgery they discover that the tract was not going to the sphincter muscles they would leave cut it open and it would heal itself. If it ate into the muscles that the seton would be in place. But no further details were given on discharge about what further action would be take after seton placement except that I'd be seen in 8 weeks. What for, I have a clue. Very disappointed. it seemed they were just in a hurry to discharge people as it was performed in 'day surgery department' meaning they didn't expect anyone to stay in the hospital over night.

 

[kelly1]

Like yours mine goes through both muscles, fingers crossed you don't suffer as long as I have been. Have you got a date through yet to see surgeon? Going from experience they may well want to do a couple of scans to get a better image of where the tract goes then they will know what treatment is best for you?
It sounds like you have had a tough time already My surgeon and care has been faultless so I guess I am lucky.
Please don't suffer if you are not happy, its you that has to go through this and suffer.

 

[AFS]

Kelly, and ManWithSeton,

You both, from the little that I understand of your fistula, will benefit greatly from my surgeon in India. I too had a high-anal fistula that ran through sphincter muscles, underwent multiple surgeries in the USA, and didn't find any cure. You don't have to suffer like I did. A guaranteed cure is available, if you can spend 3 to 4 months in India. You don't have to ever worry about this disease in your life. Read my blog for details. The treatment is scientific and methodical. My blog has links to published literature in medical journals, information that were not readily available when I looked for a cure after having been failed by the medical system in the USA. Please do not hesitate to contact me with any questions.

PS: My CRS in USA (from Stanford) was blown away by my cure and is now looking into (slowly albeit) bringing this treatment to USA. However, I am not hopeful since the medicated thread requires FDA approval, which means clinical trails must be conducted first.

 

[Crohniefor30]

To: man withseton:
Foul smell completely normal. Discharge may increase at times, and even stop for a while. I use cotton face pads and tape it over the seton to collect drainage. This helps contain the drainage very well and easily changeable (drainage burns my skin).
Good luck.

 

[CarlyL]

Hi manwithseton!!

I have had the thread seton placed twice, both times the discharge varied in amounts but always smelled quite foul unfortunately. I try to use humour to get me through and I affectionately call it 'bowel juice'. By the time my second seton was in unfortunately there was traces of fecal matter also exiting my wound site. Absolutely disgusting and I was paranoid that I smelt all the time.

As others have mentioned, the gauze or cotton pads changed every time I went to the loo helped. But I got this squeezy bottle (technical name ligation bottle) and just filled with hot salty water while I was at work and stuff to keep it clean. My GP also recommended water wipes as they are kinder than baby wipes and they kept me as fresh as could be.

I am currently recovering from the lift procedure so hoping I won't need another seton but with these things you never know.

I don't have any bowel problems or Crohns, I was a 'normal' 32 year old when my problem started two years ago with just the one fistula after a perianal abscess :-(

Sending you luck and wishes for good health, Carly xx

 

[ManwithSeton]

thanks CarlyL and Crohniefor30

the lifestyle is changed so much i.e. to replace pads/gauze on visiting loo. I just am so stressed out with this. I am a qualified engineer and have been keen on foreign opportunities especially in Middle East but because of this illness, I don't know what to do. By the time I am cured, if ever, the opportunities relevant to my career may not be available.
The thread from AFS above about India, has someone else (on this forum or elsewhere) taken up this suggestion?

 

[AFS]

ManWithSeton,

You are the first person in this form to show interest in my story. Since you asked, I will provide few more information about KshaarSutra treatment. If you PM me, I will provide Email addresses of two patients - one from Sweden, who had 6 external openings, one from Austin, Texas, USA, who had a horseshoe fistula - who both were treated in the year 2014 by Dr. Ramesh Bhat, my surgeon in India.

You are also welcome to Email with me probing questions or just call me on the phone - PM me for phone number. The difficult part about this treatment is the location - India. One must have the strongest resolve to stay in India for anywhere from 3 to 6 months. I stayed for 6 months because my fistula track was 6 to 8CM in length, so it took time to cut through.

If you don't have Crohn's, your chances of cure from this treatment are nearly 100% and chances of recurrence are less than 1%. This is what drove me to India. So keep reading my blog. Go through the publications that are linked to my blog. Medidate on it. Approach this topic methodically, like I did. You will find the resolve one day.