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How do you know if you have a perianal fistula? I have been quite sore and itchy down there, so I got my boyfriend to have a look, and he says I have a sort of spot or ingrowing hair, but he can't tell if it's going in or going out. Does that sound like a fistula? I haven't noticed anything seeping out, but I do often find that if I wipe back there when I have a wee, I have a bit of mucous or stool.


Chief Dandelion Picker
Boo, poor Rebecca.

Before mine developed an abcess and became very noticeable, it was just a tiny red spot that leaked liquid and blood (but I didn't realize it was the source of this material -- I thought it was from the "usual source"). Maybe some itching, but that was all. Does this sound similar to your experience?

The bit of leakage that you notice on bathroom trips may help explain the itching and soreness (nappy cream to the rescue).

If the spot is right in the middle of the perianal area, there is a possible second explanation, especially given the possibility of an ingrown hair: a pilonidal sinus. No less annoying, but I think somewhat easier to manage in a person with Crohn's. They are more common in males who are overweight and who spend lots of time sitting, but they do occur in females who are not overweight.

Take good care.


Staff member
I have no idea. I've been wondering the same thing about myself. My fiance said there was a bump of sorts (like a month ago) but I guess he doesn't want to get too up close and personal with the thing to inspect it the way I would. I took a shower. :p I don't have any pain though, just itchy sometimes with a little yellow when I wipe (even though I took a shower).
I googled pictures of pilonidal sinus, but they seem to occur high up the buttcrack. This is very near my anus, maybe a few millimetres away (1/4 inch). Also it's quite 'clean' looking, like a well healed piercing, or when they start to stick a needle in your arm, the skin dimples before it pierces through. I also get cracked skin higher up, so I do use wipes and nappy cream when I have a BM.


Chief Dandelion Picker
That's just about the precise location of my fistula and indeed a pilonidal sinus can occur in that location. I had an MRI to determine which it was. Fistula is perhaps a little more likely in Crohn's, but one can always hope for something else!

Do you have a GI appt coming up at which you can mention this and start to find out what it is?

Instructions given to me: seek immediate help if a fever develops and lasts for more than 4 hours -- just in case there is perhaps an abcess on the inside, or in case one develops.

I wasn't sure if it was safe to use a barrier cream on an open wound and was in *agony* until I finally got the go-ahead to do so.
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Unfortunately I won't have a GI appointment for a few months, last time I saw him I was doing so well he said he'd see me in 6 months. I can speak to the IBD nurse, and see what she says, but that will have to wait till Tuesday because it's a bank holiday weekend.

Crohn's Mom

I hope no one minds me jumping in here...
But Gabrielle just came to me and said she has a "sore" on her butt.
I asked her to explain it and asked if anything was "seeping" out.
She said it was red and itches and yes "something" is seeping out now and then, like pus?
She's not sure.

I know she had multiple "hidden"(?) fistulas pre-surgery but never any that have surfaced to the skin, so I know next to NOTHING about what they are, the signs, symptoms, looks of them , etc ?
She just started Cimzia, and took her 2nd loading dose yesterday.

I'm pretty nervous about this "spot". It is a bit higher up on her butt crack, but not all the way to the top (if that makes sense?). also its more on the inside of the crack.

Does this sound like it could be a fistula forming ?
She does have a lot of skin issues lately that looks like psoriasis all over, but has never ever had an issue of anything on her bottom until today.

Thanks all :) And sorry if I shouldn't be butting in here ( and no pun intended I swear! :ylol: )
That's where I get cracked skin. Has Gabrielle managed to take a look in a mirror? Or have you had a look? My cracks are usually vertical along the buttcrack, and you can see where the skin has kind of split and peeled away a little. I get eczema, so it could be related. Mine normally heal after a few days of moist butt wipes and cream, and I also read that rolling up a sheet of toilet paper and putting it in your butt crack can help keep it clean and dry while it heals.

From googling pictures of fistulas, they seem to be more like a spot or boil than a crack. So if she has a look and it looks more like that than a crack, best to talk to the doctor!
I wonder if I have one because I have sometimes when I need to let go of some air and hold it in, it feels a little bit like some of it creeps out of somewhere near my anus.. but not quite my anus, if that makes sense. I've looked and it looks like there might be a hole. Like you said, it just looks a but like my piercing hole in my ear lobe.

I know for sure that it's possible to have a fistula that never hurts because my rectal vaginal one has never hurt.

Crohn's Mom

thanks Rebecca,

I'm thinking (hoping) that it is related to her other skin issues (psoriasis) that has developed recently since she stopped prednisone.
I didn't realize that psoriasis can "weep" until someone told me that last night.
She did let me finally have a look and it's red, flat, and scaley; kind of about 1/4 inch in length possibly?
I gave her some hydrocortisone cream to apply and see if that helps to heal it some. If not I guess I will be calling the doc on Tuesday just to be safe.
Well I spoke to my GP on the phone, from my description she isn't too concerned, as it sounds like a sinus. She says so long as it appears to be a 'dead end' there's nothing to worry about, and it can probably wait till I next see my consultant, but let her know if there's any changes.
Cracking/Sinus of some kind sounds like the way my bum crack goes. I've been using sudocrem which dries/heals it up nicely but it comes back again each time. Wondering if its a fugal type infection which leads to irritation/etc.
sorry to invite myself in this conversation but i just wanted to let you all know that i have had silmilar things as well....the one i had high on my butt crack where it meets with my backbone was actually a pilonidal sinus, so dr had to drain, well actually dig it out and man was it deep and painful! had to heal from the inside out so i was left opened and packed...thank goodness it has since closed and healed well but dr even told me that there is no 100% that this bad boy wont come back even though she "dug it" all out....how wonderful!! but on with my story...i developed yet another bump/lump on the inner of my thigh where it meets with the groin and now have just been dx with hidradeniti suppurative. dr says it is a very rare disease but yet very common in crohns she also said that these are sometimes very hard to dx and most often are never dx at all until it becomes so deep it actually form as fistula and is so painful. just something for you all to keep in mind....if i can save anyone from having to go through what i am right now with crohns & HS then i very happily will!! good luck to you all!!