Treatment for Fistula's?

[annak87]

I've been dealing with recurring perianal abscesses and fistula's for 7 years now. When I was being treated by a pediatric GI doctor, after having abscesses drained I had a PICC line put in and did IV antibiotics for a few months at home. My "big kid" GI doctor started me on Remicade infusions 3 years ago, which seemed to keep the abscesses at bay until last November. Since then, I've had 2 abscess removals with setons being placed in the fistulas. Both times I was just sent home with 2 weeks of Cipro and Flagyl. I guess I'm just confused as to why I went from months of IV's to 2 weeks of oral meds. For those who have had abscesses and fistula's, what have your Doctors done prescription wise following surgery?

 

[s.a.m.]

I've only had IV antibiotics while in the hospital, once I was sent home it was always a few weeks of pill form and that was it.
They might have changed from IV to pills due to long term use side effects/risks of those drugs

 

[annak87]

That makes sense. I'm just wondering if the IV would be more effective and since I'm still having symptoms, they always seem to just keep giving me 2 more weeks of the oral medicine, so wouldn't that long term use cause side effects as well?..Just thinking out loud. I trust my Doctor and Surgeon's decision, they are the ones who went to med school after all : ) Just wanted to see if anyone had similar experience with meds.

 

[jkd1111]

I have had these bad boys for about 15 years now. Have had 4 surgeries for them. FINALLY went on Remicade and it has been a godsend. The GI I went to at that time was a big fan of it and it worked a miracle on me. Switched to Humira for about 18 mos but it didn't work as well and am back on Remi and don't plan to change any time soon.

The Remi has almost totally cleared them up. Just a couple remaining stubborn ones, but I can live with that compared to what I had.

 

[annak87]

Karen,

15 years. wow. How have you been able to handle it? I'm so extremely frustrated right now with these 2 fistulas I could scream. I've been on Remi for 3 years now and they kept them away for the first 2 but this past year I've had 3 surgeries for them. My most recent one was in October, had an abscess drained and seton #2 placed. I just finished a third round of Cipro/Flagyl a few weeks ago and since then, I can tell the pain/drainage is getting worse : / You say you can live with what you have compared to what you had...at what point do you call your Doctor and say something needs to be done. I don't want to feel like a total wimp so I've been holding out on contacting the surgeon and GI Doctor. Also, do you do pain meds for them or just sitz baths?
I really appreciate your feedback!

Anna

 

[Valek]

I've been dealing with recurring perianal abscesses and fistula's for 7 years now. When I was being treated by a pediatric GI doctor, after having abscesses drained I had a PICC line put in and did IV antibiotics for a few months at home. My "big kid" GI doctor started me on Remicade infusions 3 years ago, which seemed to keep the abscesses at bay until last November. Since then, I've had 2 abscess removals with setons being placed in the fistulas. Both times I was just sent home with 2 weeks of Cipro and Flagyl. I guess I'm just confused as to why I went from months of IV's to 2 weeks of oral meds. For those who have had abscesses and fistula's, what have your Doctors done prescription wise following surgery?

Hi annak87

I've had a perianal abscesses since July while in hospital they gave me antibiotics through IV then sent me home with cipro and flagyl for 10 days but the abscess came back in September which i found out i probably had this fistula since July, the clinic drain my abscess and gave me again cipro and flagyl but it didnt do to much so my GI said the best option was remicade for fistula, i asked for surgery but he didnt recommend it he said it could make matter worse.


Remicade seems to be to best treatment for fistulas...my fistula is almost gone!! ive notice a big difference compare to last September.

 

[Lydia]

The first time I had fistulas a stint on antibiotics and going on imuran got them under control. This time I used remicade and it healed them right up. Maybe a combo of drugs would help. Like Remi and imuran or switching to another biologic like humira.

Big hugs. Fistulas suck so bad. They are literally a pain in the ass.

 

[LucyAnn]

what are fistulas please?

 

[Lydia]

Fistulas are tunneling sores that start in your rectum or digestive tract. You get them exiting your abdomen or perineum/anus or vagina. They drain and are very painful. They also get infected easily.

 

[annak87]

Well I called my surgeon last week and he wanted me to do another 10 day round of Cipro and Flagyl so I'm on day 6 of that. The drainage has really decreased already but the pain is still pretty unbearable. I've being doing lots of sitz baths and taking oxycodone when the pain is at its worst. I have a Remicade treatment next Monday, so I'm crossing my fingers that this time the infection will get knocked out. So far though, my experience has been that a few days off of Cipro and Flagyl has brought on even more pain and lots of drainage (sorry for the grossness).

Lydia - thanks for the idea about adding something with the Remicade. I see my surgeon and the gastroenterologist at the end of January so maybe I'll bring that up. I'm really getting tired of just being told the Remicade and seton will heal it up. I've been on Remicade 3 years and had 1 seton in since Feb and 1 since Oct and the only time it seems under control is when Cipro and Flagyl are in my system. I'm thinking we need to think of other options at this point.

 

[LucyAnn]

Thanks Lydia,
Im not sure if that is what I have or not?
Will ask my doctor to check them next time I see him.
What ever they are they only seem to flare up and cause me problems when I have a bout of diarrhea.
xx