The 50% rule - abscess turning into fistula symptoms?

[MinusNothing]

Hi,


I've just had a perianal abscess drained.

What are the symptoms of it turning into a fistula?

 

[nogutsnoglory]

It can be difficult to know sometimes but definitely pain and continued drainage.

 

[MinusNothing]

Thanks, I'm 2 weeks post op and it's still draining is that normal, or should I be going back to doc?

 

[nogutsnoglory]

Do you have a seton placed? I would say drainage is normal at 2 weeks but when are you going for a follow up?

 

[MinusNothing]

Nope no seton, and not given a follow-up, just sent back to GP.

 

[Nsher]

I do not have Crohns disease, but the beginning of October, I had an abscess drained in the doctors office. Very painful and unexpected experience. The Rectal specialist told me that 50% of the cases develop a fistula. I had never heard of any of this so I had to come home and look it all up on the Internet.
I went back in two weeks and he said that he did not see one but he would not be surprised if one formed. It's so hard to tell if there's anything wrong because you don't know if it should be draining at that point or how it should look. In about three and half weeks after the abscess drainage, I looked at myself in the mirror and saw a tiny pinhole about at the 9 o'clock mark. A few days later I was out of town and did a lot of walking and realized that pus was coming out of that hole and then I felt like that I had the flu. I went back into the doctor a few days later I can confirm that I had a fistula and would need surgery.
I was very upset and just wanted the whole thing to be over. I was able to schedule the surgery for the next week. I made the mistake of reading horror stories on the Internet about pain levels and setons. None of that applied to me.
I was very worried. Surgery was not nearly as bad as the abscess. It only took 15 minutes. I was only on pain meds for one day and then just took Tylenol for about a week. t's been seven weeks and I am still dealing with it but the pain level is minimal. I got a good report 4 weeks after surgery.
The main issue with all of this is just the emotional stress and inconvenience. I just pray that I don't have to deal with it again after this is fully healed.

 

[nogutsnoglory]

Glad to hear your fistula healed. They are definitely unpleasant. Are you on a maintenance drug to prevent recurrence?

 

[Nsher]

I am on no medication. I suppose that is normal for a non-crohn's patient.

 

[Sailorluna]

Minus - the larger the abscess the longer it drains. If it never stops or lessens, or if you have repeated cases of healing and re-abscessing that is an indication of fistula. I think the 50% number is a misleading one. I think I read that it is closer to 80% for people with IBD and far less for people who are healthy. I just had my first non-fistula abscess over thanksgiving and it drained for a couple days and that was it - but it was tiny.

Maybe you could call your surgeon and just leave the question about how long you should be draining before it being an issue?