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Fistula AND an Abscess - What's the treatment?

I seem to be the very lucky recipient of both an anal abscess and a fistula. About 6 weeks ago I had an abscess treated and now I seem to have another. I have also had in the past a fistula, which we were able to get controlled with Remicade. The Remicade doesn't seem to be working anymore and they think I have another fistula as well. The GI said I likely have a "fistulating track." I have an MRI scheduled for tomorrow, but I was wondering if anyone else has had both a fistula and abscess at the same time? If so, what was the treatment? Was a hospital stay involved? And, does anyone know what a "fistulating track" is? This is a new term to me.

Thanks all!!!

Beth
 
Beth,

I've been dealing with abscesses and fistula's for 7 years now. Currently dealing with with them..again. I'm sorry you're having issues (and if you're feeling like me - pain as well). Okay, from what I understand, the abscesses usually pop up when there is a fistula because infection gets trapped in the fistula when it doesn't track the whole way out to the skin surface. So they basically go hand in hand. In February and October, they went in while I was under general anesthesia and drained the abscesses then placed draining seton's in the fistula's. Draining seton's are string/rubber band material that is looped through the fistula in order to keep it open and allow the drainage to flow out and prevent further abscesses from forming. I had one placed in February and another in October and they're both still in there. I receive Remicade treatments once every 7 weeks and I've been off and on Cipro and Flagyl constantly (currently on again). The surgery in February was done outpatient but in October I was kept for a few days afterwards to do IV antibiotics. I think it just depends on abscess size/what the surgeon wants to do. I hope this made sense. Feel free to ask any more questions or for me to clarify anything. Good luck with the MRI tomorrow! Let us know what they decide.

Anna
 
Thank you so much, Anna, for your reply. This definitely helps. I am selfishly hoping that it is not too serious and can wait to be addressed until next week (after Christmas). I will of course do whatever the surgeon thinks is best. This really does stink - I am sick of having these moments where I have to ask "why is this happening?"
 
Hi Beth,
Anna must be tougher than me, because she did not mention what a pain in the butt those drainage setons are. I had two last year before my surgery, and for me, they were a living hell. Maybe that's a little strong. But, if you are going 10 to 15 times a day, and trying to clean youself with those string - ouch. One wrong pull while cleaning, and OUCH. You want to hit the roof.

graphic note - The string comes out the anus and back in your body through the fistula in a loop.

I'm not sure there is much of an alternative, besides a cutting seton or surgery - both not fun options.

My solution? proctocolectomy (not done for the fistula :), but took care of that by the nature of the operation.
 
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