Perianal abscess or hemorrhoid?

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awmom

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My son is complaining about feeling a small bump on his bottom, about the size of a dime, which is causing discomfort mainly in the form of pressure, but bordering on pain. I was assuming it was a hemorrhoid, but now I am worried it might be a perianal abscess since he says his stomach is worse than it has been in a while. Would a GI need to look at that or can it be his pedi doc. He has a remi appointment tomorrow so that worries me. I also want apologize for being such a poor res ponder on this board...no excuses, as I know so many of you are also overwhelmed with a million things happening at once, just wanted to express my appreciation a heartfelt thoughts.
 
If he does have an abscess the remicade is definitely a good thing as its the best medicine for abscesses. I had two surgeries for abscesses last year which I'm still recovering from and now have a 7.5" incision which continuously drains. You should have him take warm baths and hot compresses to ease the pain/pressure
 
I would call his GI doc and ask whether he wants to see him or will defer to the pedi. Either way definitely get it looked at, as a peri-anal abscess is likely to only get worse and more painful.

Also, if it comes to needing to have the abscess lanced or opened in any way, insist upon a colorectal surgeon and do not let the GI or a general surgeon do an office procedure. The anal/sphincter area is very sensitive with a lot of potential for harm if somebody mucks around without lots of experience. Docs tend to regard abscess lancing as trivial, and it is, EXCEPT when it's on your sphincter and EXCEPT when you have Crohn's disease. I learned this the hard way.
 
I have to agree with Muppet but either way definitely have it looked at. My husband had abscess which he thought was hemorrhoid so just ignored it for the most part, ended up in hospital and surgery.
 
Wow, thanks SO MUCH for so much good information. At first I was worried that if he had an abscess, that remicade would make things worse by suppressing his immune system, so I am glad to hear that is not necessarily the case. His GI is hours away, but will have his pedi talk to him before we do anything....have already put in the calls. And thanks for the info on the colorectal surgeon!! never would have thought of that!!
 
Yep, sounds like the abscesses that Alex has had. I think hemorrhoids really only hurt while going, but could be wrong. The dime-size and soreness while stiting sounds like abscess to me. Go to whoever is easiest to get in quickly for. If it's the pediatrician, then make an appt to follow up in a couple weeks with the GI to be sure it's getting smaller. Oral antibiotics can often clear it up and Remicade helps close fistulas too. If it gets angry-red and fever, then go to the ER to have it drained. We had to with Alex's first fistula/abscess, which led to his dx. The kid could barely walk by then, it hurt so bad. I'm sure at the time I was giving him ibuprofen for pain too - I'm sure it made it worse! ah, if I'd only known then what I know now... :)
 
DON'T go to an ER for draining if you can help it. That's the mistake I made. An arrogant general surgeon made a hash of things and now my abscess is a fistula and it's permanent and inoperable. Colorectal surgeon, unless it's life and death!!
 
No advice here re: bump/abscess ~
I just want to say that you don't ever have to apologize for not posting much.
:ghug::ghug:

We're here to support each other.
So when you need us come and get it, and then, when you have time you can come and return the support to others :heart:

Best of luck
:hug:
 
I'm going to play devils advocate and just say that when I got rushed to the hospital via ambulance for my abscess it was done by a general surgeon and she has helped me more than any other surgeon/doctor could. She's the only one that would give me pain meds when my GI wouldn't, she's made me feel so comfortable with the whole process, and she has even called me personally to ask how I'm doing.

When I had my second surgery 3 weeks later due to my nurses mistake, I requested that same general surgeon. I wish she was my regular doctor.

With that being said I would definitely be cautious, but I don't think its fair to generalize all surgeons
 
To be a double devil's advocate (heh), I'll just say that there are many good reasons that many GIs don't prescribe pain meds. After my general surgeon worked on my abscess, he prescribed Demerol. He gave me more Demerol and then added Percocet each of the 6 subsequent times he cut me when the abscess continued to fail to heal under his care. All those narcs and the scarring and pain kicked off what I still refer to as my "Year of Hell." Never have I been so depressed, so ill, and so disconnected from my family, reality, career... it was a bad time.

I'm sure there are great general surgeons out there, but when the option to have a specialized surgeon exists, I think it's the smart option. I'm glad you got good care. I can't help but be a bit bitter about mine, as I'm in pain from it even as I type this, as I have been every day for 8 years now. So, take my advice with a grain of salt, I guess, since I'm a little bit pissed (that's angry, for you non-Americans). ;-)
 
muppet said:
To be a double devil's advocate (heh), I'll just say that there are many good reasons that many GIs don't prescribe pain meds. After my general surgeon worked on my abscess, he prescribed Demerol. He gave me more Demerol and then added Percocet each of the 6 subsequent times he cut me when the abscess continued to fail to heal under his care. All those narcs and the scarring and pain kicked off what I still refer to as my "Year of Hell." Never have I been so depressed, so ill, and so disconnected from my family, reality, career... it was a bad time.

I'm sure there are great general surgeons out there, but when the option to have a specialized surgeon exists, I think it's the smart option. I'm glad you got good care. I can't help but be a bit bitter about mine, as I'm in pain from it even as I type this, as I have been every day for 8 years now. So, take my advice with a grain of salt, I guess, since I'm a little bit pissed (that's angry, for you non-Americans). ;-)
Click to expand...


Oh definitely, if you're given the option than I would definitely go with a specialist. For my situation, I had no option and my abscess was done through emergency surgery. I can definitely see how you would be hesitant to trust another general surgeon and I'm sure I would feel the same way if I didn't get lucky with mine. My point was that if it does come to an emergency I personally don't think I would hold out on the operation if there was a long wait for a colorectal surgeon.
 
Thanks for your input and kind words. I made an appointment to see his pedi tomorrow, but now my son is saying he does not want to go and miss more school. He said he thinks it is a hemorrhoid and wants to wait a couple of days. In the meantime he has a remi appmt tomorrow. I will respect his wishes but will keep a real close watch the next few days. If it gets worse at least I know more what we could be faced with....thanks!!!!
 
Does your ped have evening appts or could you make at the end of the day so he doesn't miss as much school???
 
Unfortunately his Pedi doesn't have evening appointments, but I can surely get an appointment during his lunch hour. He says it is not bothering him right now which is why he wants to wait until Monday. If it is bothering him in the morning I will take him right after his remi appointment. I think they just get so tired of going to doctors and thinking about their medical problems.....seems that's all I ever think about!!!
 
there may be something on at school that he doesnot want to miss. The sooner it confirmed what it is the quicker it can be treated. Good luck
 
Hi, I definitely sympathise with getting fed up taking the kids to the doctors (and yes they get fed up too). Unfortunately not much choice these days. My son started with a small bump which then grew and got hot to touch. Don't make the mistake of going to a gp, or if you do then make them call the GI. We spent 2 weeks on normal antibiotics because I didn't realise what it was. In that time it got alot worse and he got thrush on his bottom which wasn't nice! If they need to drain it, make sure they do it under general anaesthetic - I have read quite a few horror stories on here about docs trying to drain it under local anaesthetic! My son went under general anaesthetic and it was great - he came out happier because it didn't hurt anymore :)
 
This morning he said he felt fine, no pain or discomfort.....so I am hoping it is a hemorrhoid after all. It helps so much hearing the "voices of experience" and I will keep a real close watch. How fast can it go from a small bump to a full blown abscess? I'm just worried with the weekend comming up. He is having his remi treatment as we speak and maybe that will calm things down a bit. I find it difficult lately to determine when to push him to see docs and when to let him decide. He is 17 and has been really compliant......he is just fed up, and I can certainly understand......my heart also gives a tug (for him) every time something new comes up.....I know it is the same for most here. Thank you so much for sharing your stories and input.
 
When I was 17-25 I was the most stubborn I'd ever been about treatment and probably could have used a push once or twice, but I doubt I'd have accepted it from my mom. Then again, my relationship with my mom was/is not ideal, so it's hard to advise you there.

I let my treatment lapse badly in that window, and should not have, partially because I also was fed up. How to effectively reach him and prevent that, I'm not sure. It's hard to impress the reality of lifetime consequences onto somebody that young.
 
I think it took about 2 weeks for the little lump to get worse. Just keep an eye to see if it gets bigger, painful and/or hot and red. Hope the Remicade keeps it in check!
 
Thanks...I will definitely keep a close watch. I told him what he needed to watch out for (redness, hot), and to keep me posted on any changes This afternoon he said all was well, so I am still hoping it will go away. But I will definitely continue to bug him until it's gone!!! Thanks again guys/gals.
 
hi my boy has just had his 3 rdremicade infusion he was starting with another access he we getyingbthem every 5 weeks he's had 3 ops already on it . since his infusion on Thursday he had pain that night and since then he's been fine my doc wasn't to keen on going in and giving antibiotics he said they no its gone flare up from time to time i just check it every day it swells up goes red i panic then goes down . if its staying swollen and becoming red and hard . draw a pen mark around the redness and u.ll see if its getting any bigger or i.d just make him down to ere and ask for the Castro regarding on call before a surgeon goes wadding in to drain or lay open it can cause more ptobs for a crohns patient to have surgery as the healing process of the inflamed area can take longer and heal badly . hope Italy not an access as there a bloody pain of our lifestyle at the min .xx
 
Hi Lewis's mum, Thanks for sharing your story. I am keeping a close watch and thanks to all of you will know what to look for and ask for should I need to see a doc...you all have helped immensely. It sounds like you and your son have gone through a lot. I hope the remicade continues to work for your little one. It is so hard to see the kids suffer with this.
 
don't wait get it checked soon. my son had hemorrhoids and one day he told me he had a hole in it. We took him to the doctors and they said it was just an abcsess after weeks of nothing working it became worse. He has a fistula and diagnosed with perianal disease two months later. He has to bathe after each bowl movement and with his crohns that a lot. he's on remicade now. It is very hard to get under control so start now before it gets worse.
 
Nothing to add hun except to say good luck and I hope your boy has relief soon...:hug:

Dusty. xxx
 
Wow, princezekristal, I'm sorry to hear your son has had to go through all of that. I think I need to heed everyone's advice and just get it checked out. Will try to get an appointment with a GI this week. Did your son have any pain when you thought it was a hemorrhoid?
 
My son's abscess got better with Flagyl. Pain was gone within 12 hours. His got really bad tho...he couldn't even walk! (And it was after his 2nd dose of Remicade...but my son had allergic reaction on his third dose...so maybe that's why Remicade seemed to make it worse).
 
Thanks all. Well, we still have not seen the doc. He says it is getting better. He is conscious that it's there but it doesn't really hurt..itches at times. He wants to wait until Thursday. It's good to know that Flagyl works fast! Funny that you mentioned Flagyl.....he asked the other day if he could start it again because it helps him with his "stomach" issues....hmmmm.
 
also hoping things are going well for you. missed your thread the first time around but wanted to second the sentiment...never apologize for not posting...we all do what we can here and we all understand what it is like. :)
 
Aww, thanks for checking on him guys. He seems fine....says he can still feel the bump, but there is no pain. He asked me to cancel the doc appointment. We are traveling to Boston next week to get a second opinion on his possible surgery and overall treatment, so we will have them check it then. Thanks again for checking
 
Boston children's in mass? if so, we love it there and hope you do too! good luck with your second opinion! :)
 
Gosh Kim, I am SO glad to hear that they are awesome....I was beginning to question my reasoning for going there VS somewhere else. You have made my day! Thanks.
 

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