Possible abscess? Why are my symptoms coming back?

[crohnie4life]

Hello All,

I am new here and I'm hoping some of you may be able to give me a little advice! I will try to make it quick. I was diagnosed with CD at age 10, I'm 25 now. I have gone most my entire life med-free and relatively symptom free. I've been extremely lucky.

Recently there have been several extremely stressful events to occur in my life which has resulted in the worst flare of my life. Back in October I had a week long hospital stay due to extreme abdominal cramping, fever, constipation, and vomiting. They dosed me up with solumedral (?), Flagyl, and Cipro. Did CT scan and small bowel series. They suspected a possible abscess and/or fistula forming... however after a week I felt ok, was released, and scheduled an appt with a GI doc after a couple weeks. Sent me home on antibiotics, pentasa & prednisone 40mg tapering 10 each week (1 month total)

Once I tapered to 20mg all my symptoms came back with avengence. I did not make it to my GI doc and landed in the hospital again (in November). Worst pain I have EVER felt!!! I could not even stand up. I have a high pain tolerance and I was in tears. Scary...

MY QUESTION IS- What does an abscess feel like? What are the symptoms? My bowels were so swollen at the time of the CT scan and small bowel series that they could not tell for sure if there was an abscess or fistula present. Just saw a partial blockage. I'm tapering from 40mg prednisone again, this time at 5mg each week. I am currently at 15mg of pred and starting to feel symptoms again. I also started on Humira 5 weeks ago and am not noticing a difference. Could it be possible I have had an abscess all this time and its symptoms have just been masked by the pred?

The only way I know how to describe how I feel right now, is just that I feel completely uncomfortable all the time, it is worse after I eat of course. It is bearable I suppose but not comfortable in the least. Definitely not normal. My dr had me on vicodin for a month and that helped tremendously (I miss it because it helped me through each day but am afraid to ask for it again bc I don't want my doc thinking I'm a junkie)... I feel constantly full, extremely exhausted, pain comes & goes (and I'm scared it will get worse again), I feel like I can always "feel" my insides... tonight I took my temp and I had a low grade fever of 99.8. However my bowel movements have been regular and normal??? Also, not sure if it's in my head, but I noticed tonight also an slightly red, raised bump in the lower right of my abdomen (where the pain is). I'm starting to freak out that I could wake up to a hole in my stomach from the things I have read!

I'm going to call my doc next week & see if I can get in sooner to see him (next appt is Jan 21st)... He doesn't want to do a colonoscopy until the swelling is down but at this point I feel like there's not much swelling but something else going on that needs to be looked at??

Like I said this is my first major flare so I'm sort of clueless, and definitely panicking! If anyone takes the time to listen to my strife & respond, THANK YOU! AND I LOVE YOU!:sign0085:

 

[Grumbletum]

Hey there, first of all a big warm welcome to the forum. Glad you found us I'm sorry it's cos you're flaring though. I'm afraid the symptoms you're describing do suggest a possible abscess.
I had one where my bowel was fused to my bladder. Like you, I very rarely suffered from D and had pain that varied in intensity, but was worsened by eating. I had pain in my LRQ that seemed to move around a bit but there was one spot in my pelvic area, right in the middle that was pretty constant. You could see and feel a sort of bump or ridge there and it actually felt hot when you put your hand on it.
I hope you can get in to see the doc sooner. It took 6 months on meds for my abscess to shrink - a combination of Pred, Mesalazine, Azathioprine and antibiotics.
I did find that watching what I ate and cutting out irritants releived my symptoms a bit. Not the best time of year what with all the Festive food and alcohol around...

 

[DustyKat]

My son had an admission for a suspected micro perforation and abscess but at the time they couldn't find it. He also had a week in hospital with IV steroids and antibiotics, actually it was this exact time two years ago, which alleviated everything and he was discharged Christmas Eve.
His primary symptom was pain. He couldn't stand up straight, walked with a limp and when laying down it was the most comfortable to have his right knee flexed. His abscess was located on the psoas muscle. He always described the pain as a tightness, stinging type of pain when things were more settled. His bloods did reflect inflammation and infection present with a significantly increased CRP (C Reactive Protein) and WCC (White Cell Count). It was the WCC that had them searching for an abscess, plus how his pain presented.

10 days after discharge he presented to the ER again with the same symptoms. Pain was worse and when admitted his CRP and WCC were much higher than the first admission. Again they could not find the abscess and again he was put on IV steroids and antibiotic. This time they rescanned after about 5 days, when the bloods indicated that the inflammation and infection was greatly reduced. It was then that they were able to the find abscess.

They put a percutaneous drain in to drain the abscess and then did a sinogram (injected dye through the drain) and found a communicating fistula.

Do you know what your bloods are doing?

Dusty. xxx

 

[crohnie4life]

Thank you both for your replies! You all seem so welcoming and helpful

Grumbletum what you described seems eerily similar to what I'm going through- I've also noticed extreme pain/discomfort when my bladder is full and I go to relieve myself! Did you have any of that? I have pain on my lower right side but also like you described, a constant pain/discomfort in my pelvic area... but no lumps or bumps really.. hmmm

Dusty- Your poor son! Ugh! I hope he's doing much better since. I'm not sure what my bloods are doing. I had some blood work done the first time I saw my GI to see how active the disease was... he did not say anything about it to me (I should have asked...)?? The last time I saw him I did ask him if I should have blood work done a 2nd time and he said it was not necessary (which I thought was odd). So it has been probably 6 weeks since I've had any done.

I do know my hemoglobin while in the hospital was down to 7.5 and I received 2 pints of blood. I've been extremely tired...

Thank you for your thoughts, guys. I called my doc about an hour ago and am just waiting to hear back from him...

 

[Grumbletum]

Crohnie, I had a lot of trouble with UTIs and pain when urinating because of a bladder fistula. If you have inflammation near your bladder it can cause pain and irritation. If it's a fistula, you'd probably notice that you're passing air when you pee and/or have bubbles...or worse...in your urine.

 

[crohnie4life]

Thanks Grumbletum... So I was in such bad pain 2 days ago (in tears and took my breath away) and had no pain meds to help (except tylenol which did nothing), I checked myself into the ER.

I was admitted and they did another Catscan... to my surprise it showed no abscess/fistula... simply an exacerbation of crohn's. So yes I guess I just have a lot of inflammation down near my bladder causing that pain and discomfort. Which, is good I suppose!

Put me back on a higher dose of steroids, some antibiotics, and more pain meds... My doc is thinking Imuran is probably in my near future so I can get off of these steroids. I'm just getting frustrated because this is my 3rd hospital stay in 3 months. I just want the pain to go away and to be comfortable!!! I think that's all any of us Crohn's sufferers want On the bright side at least I was discharged on Christmas and didn't have to spend another week there! Merry Christmas to everyone!