Round red itchy patches under wafer

[kitmus]

Recently diagnosed with Crohn's in small intestine after 25 years remission. Developed abscesses, fistulas around stoma, but not on it. Doc prescribed both Cipro and Flagyl for 21 days. Will see the stomal nurse and ID docs on Monday. Patches have just occurred concurrent with very hot weather. They are only under the outside of the wafer, perfectly round, some oozy and all itchy and not raised
. Any thoughts? Thanks.

 

[PsychoJane]

Well... round and itchy makes me think of some sort of dermatitis or may be fungal infection. I think I would try some anti-fungal cream on that.If I remember right I think you can get Nystatin powder. I'm guessing that prepping the area with this and spraying some skin-prep on top could be helping if it is fungal. I am under the impression it could be it since it is coupled with the hot weather and itchy. It could also be inflammatory, cortisone would be better in that case. I think it worth asking your pharmacist about it but I believe there are some combination of both cortisone and anti-fungal agent that are available. Otherwise, I know that I would have bruise like feeling and red round appearing before new fistula would show up but it was mostly the pain that was my Q signal to know that this was happening.

I hope this helps,

 

[kitmus]

Thanks for answering. Inclined to think that it is either, and/or fungal or perhaps, yeast. Will hopefully get an answer tomorrow. I am currently in the throes of decision-making regarding surgery or biologics to treat about 4 cm of small bowel which is involved in a "bout" of Crohn's after 20 years, inflammation,abscesses, complex fistula, etc. Surgery is being recommended by GI doc at Mayo, where I was referrred because of recurring abscesses. The recommendation for surgery is based on my past pattern of surgeries, i.e. no infection, fast healing and long remission afterward...indolent form. I would have to have a resection. I am 72 and doc doesn't like the biologics because of age-related suseptability to infection, exacerbated by the immuno-suppressants. Thought the forum might help, but so far everyone has evenly divided thoughts that I can see. Have two more visits in my hometown with a GI guy and my primary care...so hopefully I can make a decision soon. If you care to comment on any of this, please feel free!

 

[PsychoJane]

Waaa, it is not an easy choice to make. It is sure that surgery can be harder as we get older but at the same time, I've seen many of my relatives that got surgery (not crohn related) at about your age and they did fine.

I dealt with the same situation, only a few cm of bowel were highly involved in the formation of fistula and the rest of my bowel was in good shape. I too have that tendency for long remission post-surgery. It's harsh on the body, but in my opinion, anti-tnf and immunosuppressants also impact the body greatly. I see it as having the choice to impact your body greatly once (with the surgery) or spending years asking your organ to deal with quite taxing medication. Some gets no side effects from them at all but others ends up getting lots of fatigue and undesirable effects associated with the treatment.

If the condition of your bowel is great elsewhere and that your overall condition is good and I'm guessing that this might be a better choice to opt for surgery. I mean, trying the anti-tnf/immunosup could be beneficial but if I only rely on my experience, I would push towards surgery and would have gone for it way earlier in the course of my disease (fistula part) if I would have had the choice.

 

[kitmus]

Good stuff; thanks.