Problems with fistula? Help with symptoms

[guest78]

Hey all.
I have a few questions I hope someone can help me with.
In September I had a horrible flare up of my Crohns despite being on Humira and Aza. I also developed a perianal flare for the first time. I was suffering with a high temp and extreme pain going to the toilet as well as blood in the stool. i was put on two seperate sets of antibiotics. Which made things a bit more comfortable but when i ended the meds, the sunptoms came back. I ended up in hospital and an MRI showed a tiny absess and fistula. I was put on pred, on top of my aza and Humira. As well as more antibiotics.
I began to feel better, finished the antibiotics and started to lower steroids.
However, as of about 10days ago I am suffering again with pain sitting, intense pain passing a stool, some stomach cramps, some leaking/discharge and blood in stool.
I don't know if this is a fistula/absess? Or the peri anal crohns.
I'm worried that despite being on all this medication it has reoccurred. I don't know what the next step would be. I'm really quite scared.
I'm seeing my Dr tomorrow but feel really nervous as to what can be done.
I have spent months being very unwell. It all feels never ending.

Hope someone can help!

 

[guest78]

is having a fistula / abscess the same as having perianal crohns?
or are they different thing?

 

[AlliRuns]

I think fistulas and accesses are the definition of perianal crohn's. My doc has also labelled it "fistulizing Crohn's".

 

[guest78]

Thank you! That has never been explained to me before!

 

[AlliRuns]

Hadn't been explained to me either until I found my current GI team.

 

[AlliRuns]

I have always found that antibiotics only help fistulas while on them, but even taking the antibiotics, I have found them to lose effectiveness after about 6 weeks. I have had 7 years of being on and off flagyl, it's not my favourite thing.

 

[guest78]

Yeah exactly. I've been on antibiotics 3 times now and just as they start to make a difference I finish the ourselves and 4/5 days later all the symptoms return.
I'm worried what the next course of action will be.

 

[AlliRuns]

Well since you're already on Humira, there goes biologics as a next step.
I had antibiotics, more antibiotics, surgery, more surgery, more antibiotics, next step is biologics, maybe, if my health plan will cover them, still waiting for an answer on that one.

 

[AKCrohns]

I too have done the antibiotics (way too many!) for a fistula with no success. I developed a large perianal abscess turned fistula a year ago that was treated with antibiotics, surgery, more antibiotics, biologic (Remicade), two more surgeries. The fistula closed thanks to Remicade and Aza but I'm still fighting with the wound itself to heal. I've been on Flagyl ointment since Sept to try and keep infection out of it which is way better than the oral stuff!

 

[AKCrohns]

Oh, and I hope you are able to get come clear answers from your appointment!