Fibrin Glue Injection for Anal Fistulas

[JLOWE64]

Hello to All,

I am new to the Crohn's Disease Forum. My wife was diagnosed with Crohn's when she was 18, (she's now 48). She was mis-diagnosed (to put it mildly) for for more than a year as Anorexic. By the grace of God a young doctor figured out that she had Crohn's and performed emergency surgery to remove approximately 3 feet of her small intestine. This was in 1983, and until about six years ago she kept the disease under control with a diet and quiet lifestyle. In 2007, a perirectal abscess (and subsequent fistula) required surgery. Kaiser Permenente required her to go on Remicade before they would treat the fistula. She stopped after 4 or 5 treatments due to side effects, Kaiser refused to treat the fistula. She's been living with the fistula ever since.

Has anyone had a Fibrin Glue Injection to treat an anal fistula, or know anything about it? I've found a case study that says it very good treatment option. The problem is that I can't find anyone that is doing it. Any help or ideas would be greatly appreciated.

Thanks

 

[AlliRuns]

I believe there is an old thread about this, but it doesn't seem to be the norm.

 

[AlliRuns]

http://www.crohnsforum.com/showthread.php?t=17448

 

[bigtruck]

Unfortunately in crohns patients the success rate of fibrin glue is very low, has her doctor discussed any further treatments with her?

 

[JLOWE64]

I found a several case studies that put the long term success rate of greater than 50% with no risk of incontinence and the procedure can be repeated if it doesn't take the first time. I just can't seem to find anyone who does it in Southern California. I think it is a money thing. Why would a doctor cure someone for $2,000 when they can operate for $12,000, right? That, or put them on a lifetime medication regiment. Sorry if I sound a bit cynical.

 

[bigtruck]

I know where your coming from but I think it's different in people with crohns another of the problems my surgeon mentioned about it is that sometimes a bit of the tract heals but not all which then results in a build up and ultimately an abscess, don't get me wrong I'm not trying to put you off I have fistulas myself and would try anything, but they really are hard to deal with both surgically and medically. Are you on any medication for them? Do they discharge much? The conservative approach is usually the best way with them.

 

[AlliRuns]

http://link.springer.com/article/10.1007/s10350-004-6589-y?LI=true

The study in the above link had a 69 percent success rate but all patients had an initial surgery with seton placement which was let in for 2 months and only 10 percent of the patients had Crohn's disease.

 

[bigtruck]

Agreed alli a very small percentage had crohns it seems to be much harder with Crohn's disease.