Newly diagnosed-now abscess and fistula

[kernelmom3]

My 15 year old son was diagnosed with Crohn's about three weeks ago. His colon was perforated during colonoscopy and he had surgery a few hours later to repair. They were able to do the repair laparoscopically and he had IV antibiotics and a drain. He went home a week later without drain or antibiotics. About a week and a half later, he got a fever and stomach pain and had a CT scan that showed an abscess. They admitted him again and gave him IV antibiotics. He came home four days later on oral antibiotics. He just had a follow-up MRE that showed the abscess is stable (hasn't gotten bigger or smaller) and he has a fistula. GI didn't seem too surprised or concerned....should we be? We have an appointment in four days to see GI and schedule his first Remicade infusion. Does Remicade heal abscesses too? Draining isn't an option because the abscess isn't accessible for interventional radiology. What if Remicade doesn't work? How are they healed? Thanks for any answers, advice, etc. we've been kind of thrown into this and its been a roller coaster to say the least!

 

[Grumbletum]

Hi kernelmom3 and a big warm welcome to the forum. I am so sorry to hear about the issues that your son has been having. The two of you must be reeling.
To answer some of your questions, several people on the forum have had fistulas heal on Remicade. I will be honest with you though, it has a better track record with external abscesses etc ( i.e. perianal ) rather than with internal/intestinal ones. Do you know if it is tracking to another organ or another section of the bowel?
I had one from bowel to bladder which did heal for a short time, but opened up again when the Remicade was stopped. The next step for me was surgery to remove the damaged sections of bladder and bowel.
I don't mean to worry you and I know the thought of surgery can be very daunting, but I have been so well since mine and have been in remission for 2 years now.
Please fire away with any other questions you may have and let us know how things go with the GI appointment.

 

[kernelmom3]

Thanks so much for the reply Grumbletum (love the name)! My sister was diagnosed with Crohn's almost 20 years ago and had a bowel resection almost right away. She's been in remission since then so when we got the diagnosis I knew what we might be in for but we were pretty optimistic. It's a lot different wen it's a child...MY child (even if he is 15!). I've always been terrible at waiting and it has been pretty much a waiting game. Wait and see if the antibiotics will heal the abscess. Wait and see if Remicade will be covered by our insurance. Wait and see if Remicade will help the Crohn's/fistula. Now we're waiting for DS to have a bowel movement after drinking barium for the MRE! I got so stressed a few days ago, I literally couldn't feel my feet for a few hours! He had the test two days ago and hasn't gone yet but has no fever or nausea so hopefully it'll be soon and we won't be heading back to the hospital!

 

[kernelmom3]

Thanks so much for the reply Grumbletum (love the name)! My sister was diagnosed with Crohn's almost 20 years ago and had a bowel resection almost right away. She's been in remission since then so when we got the diagnosis I knew what we might be in for but we were pretty optimistic. It's a lot different wen it's a child...MY child (even if he is 15!). I've always been terrible at waiting and it has been pretty much a waiting game. Wait and see if the antibiotics will heal the abscess. Wait and see if Remicade will be covered by our insurance. Wait and see if Remicade will help the Crohn's/fistula. Now we're waiting for DS to have a bowel movement after drinking barium for the MRE! I got so stressed a few days ago, I literally couldn't feel my feet for a few hours! He had the test two days ago and hasn't gone yet but has no fever or nausea so hopefully it'll be soon and we won't be heading back to the hospital!

 

[Grumbletum]

Ah, poor boy...and poor you. Yes, the waiting is awful isn't it? Is he is in pain/bloated from not having a BM? The only thing I can suggest really to help things move along is drinking plenty of water - and maybe hot water which can be quite soothing.