What's the secret to healing perianal abscess?

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allicat1214

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It seems like so many threads that discuss abscesses indicate they come back....Has anyone actually had an abscess actually heal after just one occurrence? If so, what is your secret??

My son who was diagnosed with Crohn's last summer, developed a perianal abscess that was drained in the ER on July 4th. He came for follow-up this past Monday and surgeon said it had to be re-done in OR under general anesthesia. That happened on Tues, he's been in hospital since then. They dug out major tissue....all indications are no fistula, but abscess went right up to rectum. No signs of crohn's in rectum...but anus was sore and raw from procedure when they did a little biopsy to determine if crohns.

They were giving him Zosyn & vancomycin IV, nothing extra for Crohn's just his 9 mg of entocort and pentasa.

They gave him miralax to avoid hardened stools with pain meds he was on, but that seemed to cause major D in hospital. I asked two nurses and a doc whether he should still be taking miralax since he had several bouts of D a few hours after taking it. Colorectal surgeon said he had to stay on it to avoid hurting abscess, but finally spoke with the GI docs and they said yes, take him off!!! Thank God!

So he is going home today with percoset for pain to be used when packing is changed daily and augmentin. They are setting up Home Health to come out daily to change packing. Thank God for that, too! ER had me try to do it with initial drain and he almost fainted when I tried it!

Besides Zinc, Vitamins A, C & E, probiotics, what else can I give him to expedite healing and prevent recurrence of abscess? He goes back to college in a month!!

Thanks in advance!
 
Protein is a good healing agent---meat, fish, eggs are all low fibre options for boosting protein.

I wish I had an answer for your question about how to permanently stop abscesses from occurring, Allicat. I've had them for many many years, but I've never had any medical intervention. The minute I feel one coming on, I call my GI straight away and he puts me on antibiotics. The symptoms that trigger me to assume I've got a fistula or abscess happening are: high temperature, chills, night sweats, lack of appetite, etc. I figure that even if it's not an abscess or fistula, the symptoms indicate some kind of infection, so a 2-3 week course of antibiotics wouldn't be the end of the world, regardless.

When I can feel it on the outside of my anus, I begin to hot compress it several times a day for at least 10 minutes each time (soaking in a hot bath would be helpful as well). Keep the water as hot as possible. Within a few days, the abscess 'breaks' and the puss and other stuff starts to drain out of the abscess. I continue to hot compress until the pain subsides and I can begin sitting again, which is usually quite soon after the abscess breaks.

Don't know if this is helpful for your son or not---abscesses are horrendous and they sure do knock the stuffing out of a person.

I wish him well in his recovery.

Take care,

Kismet
 
I'm sorry to hear about your son. He's the same age as me and I know its tough going through all this. I've googled but I still don't know what abscess/fistula are or how you even know you have one. Sorry I'm no help!
 
Hello, sorry to hear your son is suffering with abcesses, I know how painful they are. Hope he is on the mend soon

I have had a few abcesses that burst and turned out into fistulas.I dont think there is any secret to them healing but they can take a lot of time and patience to heal.

I have had packing in the open wounds left by the abcesses . My poor wife had to change them daily!!. After a while they healed to a small holes which were the ends of the fistulas.

I had surgery numerous times to have seton drains put in the fistulas and that is what healed them up in the end but it took a long time.

I will say that after a short while of living with abcesses/fistulas it just becomes the norm and part of your life keeping them clean etc, and working out how you cope with them is different for everybody.
 
Hello---

Glum chump your information makes me feel a little better. In regard to this, I have a question for you all...

How often do these abscesses occur? I just discovered my first. I am in a similar situation to allicat's son. I have had Crohn's for 8 years and had a resection 5.5 years ago. I had no symptoms following the surgery for 5 years until this past February. I have been on Entocort and Pentasa. I have finally weined off of Entocort. I was having trouble sitting down a few days ago and I went to the ER to find out I have a perirectal abscess. I went to a colon-rectal surgeon and he said the abscess has burst..

In terms of treatment I have a few options. I am on antibiotics and have started to feel better. I can sit again, thankfully. The surgeon told me I can either have a seton put in or continue to request antibiotics every time it re-occurs. I am hesitant to get the seton, but I'm hoping these episodes are infrequent.

I, like allicat, am wondering about how to prevent it from happening again. The research I've done suggests it will keep happening, but how frequently has it happened for all of you? I'm having trouble making this decision. If you could all offer your input I'd appreciate it.

Thanks so much & Good luck!

Vanessa
 
Its difficult to give advice because everyone is different. But I have been abscess free for about 8 years and the complex fistula (that took 7 years to heal via about 5 EUA's and the same amount of seton drains) disappeared about a year ago.

The seton drain was the only route for me as it gave the best chance for it to heal up and I didn't need to take metronidazole and more (which made me feel ill) plus we all take enough tablets already for our condition.
 
I am sorry to hear you are having bad times with abscesses.

I had a perianal abscesses once, doctors drained it and it healed.

I don't think there is a secret on this. I mean I cannot say anything special about it.
It wasn't so big but very painful. All the area around was Inflamed. It wasn't located deep inside since I could feel the pain just when sitting.

I remember I went to hospital to ask about it and by my surprise they decided to drain it right the way.
They used a syringe to extract the pus inside it and check how bad it was. Then, in the same procedure they gave me local anesthesia and did a small cut on the abscess.
The releaf came in a couple of hours and after few days the cut they did healed.

I think there are local treatments for that such as suppositories, unguents, etc.
 
Hello Alicat,

I doj't have an answer sadly, but I just wanted to say I undestand how you feel. My little son (5 yo) has has a perianal abscess and fistula. It has been a year so far and not yet healed fully.

But I wanted to say that he is in no pain with it. The absess was initially very painful but once that was drained it stopped hurting basically. He has had some treatment for the fistula. I wish the fistula would heal, but I have to remind myself that it doesn't bother him now which is what matters.

I hope that helps. I think some fistulas can heal quickly, not all of them take a long time.

Take care,
LilyRose
 
Sorry to hear about your son, I know his pain.

The only thing that closed the fistula, after the "laying open" surgery was going on Humira every ten days. The fistula closed in two days.

In Crohn's patients usually abscesses come from fistulas that tunnel and create a pocket, hence an abscess.

Good Luck and tell him to keep a positive attitude!
 
Hi Alicat,

How is your son going? Is the packing going OK, I hope the pain is settling down.
take care,
LilyRose
 
I had a perianal abscess in 2005. It was drained under general anestisia and then packed for 6 months until it healed. For 6 years I was abscess free. I have been on many meds for crohns and after my son was born stopped remicade and all meds completely. For a year and a half i had daily symptoms but nothing too bad. A few weeks into my 2nd pregnancy my crohns intensified and the perianal abscess came back in the same location. I had it drained over the weekend an currently have a malecot cathator in the wound to allow the area to heal without packing. They say it should come out in two weeks and at that point they will determine if I have a fistula,which they believe I do. They mentioned a seton but that is new to me. Just because my abcsess took 6 years to reoccur does not mean that it cannot happed again faster. I am now considering Humira. I know my GI will suggest it at my next appointment. Surgury scares me and I do not want to go through this again so I am more focused then ever on getting my crohns into remission for the first time ever. I feel for your son. This is hard enough on adults it must be awful for children.
 
I recently had a perianal abscess drained, and it healed in 2 weeks. I was on a high protein diet and I also showered after each bathroom trip to avoid infection.

Hope your son has a speedy recovery.
 
I first got a peri-anal fistula and abscess in 1998. At the time I had not been diagnosed with Crohn's and visited my GP who gave me a course of anti-biotics. This reduced the infection, but did not get rid of it and after 3 years of intermittent problems, I was referred to a surgeon in 2001 and had it laid open and packed. It was quite a big fistula, probably as wide and deep as one of my fingers, so this was not a pleasant process.

This improved things, but the surgeon could not get a seton stitch in and warned me that there was a good chance it would come back, which it did. I had surgery on another two occasions over a period of 4 years before it was finally cured in 2005. The key for me was getting a setan stitch inserted and allowing this to cut through the fistula over an extended period. With this sort of problem, you have to be very careful with surgery as it can lead to being incontinent if the wrong muscles get damaged. I was very fortunate to be under the care of one of the best surgeons in the business who did a great job.

I occasionally get some soreness from that area when I am having a flare up, but it has never burst and bled as it did before the surgery. Generally, I think it is very hard to solve this sort of problem without surgery.
 
My abcess turned into a fistula. I had minor surgery to insert a seton stitch. After about 2 months the stitch cuts the flesh down to the muscle, not painful but uncomfortable as the knot in the stitch can move completely into the fistula track. After the stitch was removed the fistula continued to drain for about another month, then finally healed over. Time, patience and cleanliness healed it. I cant imagine being a child or teen with crohns, life's tough enough without this affliction. Keep positive.
 
I had a perianal surgery 4 weeks ago and told today all is good ,the wound was golf size ball and about 1.5 iinch deep. The nurse is very experienced, she changed the packing every day for week 1, 3 times a week in week 2, and then twice a week in week 3 and week 4, 5 only outside bandage change.She gave me allevyn bandages and asked me to keep the dressing in and change the outer a packing if it gets soggy. The would was leaking foul. She said fiddling too much with the wound causes prolong healing. I was spraying the outer wound with dettol and drying it and placing the bandage over existing packing everyday. Nurse was changing the packing.

Dr gave me only one week antibiotic, which I requested more and continued till 2nd week. The maximum amount of co amixiclav 500/125 capsul allowed is 2 weeks anyway.

I stayed in bed for three weeks, no movement and pressure on wound, sitting a bit.
Week 3-4 Llight walking , was going out for taking fresh air. Oxygen help to keep circulation going and additional protein in red meat (salmon ) provides zinc required to heal wound fast.
Week 5 resuming normal activity. It's heald and (touch wood) completely gone only tiny hole and split pea size depth left.It looks like nothing was there before. Now only outside covering with bandage and no need for packing.

Additional help: stay positive, the abscess are caused by stress and flair with stress.
Diet:Lots of fish, yogurt , orange juice , fruit , green veg( yes lack of zinc in body contributes to the abscess).No skipping meals, three times a day large plate of food n salad.
Avoid milk, it causes pus, I drank orange juice with half tea spoon turmeric in it to Fasten the healing and increasing antibiotic in body , i took it for few weeks.For bowel movement, took fybogel ( spaghula husk) drink so no strain at bottom.

I was so scared thought it will never go, but believe me it will heal soon. It needs care and dedication. I am 37 years old and average built! Don't have crown disease but I think there may be something here I can help with, abscess are nasty but get cured. I have been reading online to change packing everyday for 3 weeks post surgery and was anxious what nurse was advising me but in the end it worked out ok due to experienced nurse. The surgeon tod me to keep the wound dry, I used baby wipes after bowel movement, first werk only hot towel clean then wore water proof nappy before shower carefully, no baths .the nurse wipes it and uses salin water before packing it. Nurse told me no more packing is requred as the wound is inside like a pea nd outside tiny hole.only outer bandage is applying.

Hth.
Hth.
 
hi guys was diagnosed with crohns in april 2012 and it came completely out of the blue, i was only 4stone 10 pounds when i went into hospital and was completely under nourished. I was in hospital for a total of 5 weeks and my symptoms seem to not be as bad as they were. I am on a lot of medication but now weight 7 Stone.

While in hospital i had a drain in for a week, they was draining a collection in my right buttock. after a couple of days of being released, an abscess formed around the drainage site and eventually burst and all of this pus came out, it ran out for about 10 days and i was given flucloxacin to clear it up. Now last few days abscess has returned in the exact same place and yesterday i had it drained. although it had just burst again they said they wanted to open it up more in order to get it all out. i was wondering if anyone knows how long it is going to take to heal?

The cut is about an inch deep and has to been packed with gauze and heavily dressed otherwise it leaks everywhere. it is really painful aswell when they pack it. Thanks
 
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From what I've gathered, if you have your Crohn's under control then the rest will stay away. Whether the Crohn's is under control through medication or diet. I'm currently waiting for a two month old abscess wound to heal and the surgeon told me (5 minutes ago in fact) that the only way for it to heal is if the Crohn's calms down.
 
Perianal Crohns can be very difficult to treat. There are a few general principles.

1. Usually pain means pus and pus needs to be drained. Should also be on oral antibiotics, ciprofloxacin would be the best, well tolerated. MRI of the Perianal region probably the best test to give a roadmap of the fistula(s).

2. If you have a fistula that is discharging then you should have a non-cutting seton stitch inserted, the role is just to keep the fistula tract open so drainage can occur and an abscess doesn't redevelop.

3. Once drainage is secure (ie. abscess drained and seton in) then you can look at treating the fistula - biologic therapy in combination with antibiotics is the best for this.

4. Once the drainage from the fistula stops the seton needs to be removed (the fistula tract won't heal with the seton in, it's job is to keep it open) to allow the tract to heal. Usually a good time is between the 2nd and 3rd loading dose infusions of Infliximab for example.

5. If the Perianal disease is truly ruining your life, then a defunctioning ileostomy is a possibility, although successful reversal is rare.

6. Need to control luminal Crohn's which can drive the fistula, so,will need endoscopic assessment, particularly of the rectum.

Good luck.
 
I wish there was a secret!! Everyone is different but for me, I've had them since 2006 and they don't seem to go away, they always come back. My abscessing developed while on remicade, anti-biotics are not working and neither is Humira. Boo to abscessing and fistula! Sorry I don't have the secret. All the best.
 
Hi Smallfry, if you're getting a lot of abscesses that aren't being driven by poorly healing perianal fistulae, it might be worth seeing a skin specialist to exclude a condition called Hidradenitis Suppurativa, can be commonly mistaken for perianal Crohn's.

Best wishes.
 
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I've had two perianal abscesses, thankfully they both healed on their own after drainage and haven'r recurred touchwood. Intestinal abscesses however just come and only go with long hospital stays, tpn, iv antibiotics and iv hydrocortisone. Then reoccur a few months later. I wish I could advise some magic bullet, Aussies advice (above) seems pretty good though. All the best,
 
shmo said:
From what I've gathered, if you have your Crohn's under control then the rest will stay away. Whether the Crohn's is under control through medication or diet. I'm currently waiting for a two month old abscess wound to heal and the surgeon told me (5 minutes ago in fact) that the only way for it to heal is if the Crohn's calms down.
Click to expand...

This is what both my colorectal surgeon and GI have told me. My first experience with an abscess was in 2006. I was first put on steroids and antibiotics, but these only suppressed it, making it impossible to find and drain and more painful. Eventually it did come to the surface and was operated on, packed, and seton placed for a short time. It healed well and never reoccured until beginning of this year when my body stopped responding to all conventional therapies. I've had 5 procedures in the last few months to drain multiple abscesses/fistulas and have several setons in place, and still have one abscess that is too deep to operate without causing permanent damage. Anyway... bottom line is that as long as the crohn's is running amuck, the fistulas and abscesses will too! My first one healed successfully because my crohn's was being controlled with biologics.

Being that I'm not on any crohn's treatments for now, I have been attempting to alleviate them via nutrition (TPN) and supplements. I have not had any new abscesses since starting TPN, and the deep one seems to be doing a little better, though it's hard to tell if it's the TPN, antibiotics, or pain meds, or all three! Oh, and frequent hot epsom salt baths do wonders for alleviating the pressure! I really hope your son's heal well and stay gone! My personal opinion is that a seton is the way to go. His colorectal surgeon can work with him, and graduate down to smaller and smaller setons until they are no longer necessary. Good luck with everything, I know how much of a pain in the butt these things are!
 
AVW, I was wondering if you are in hospital on tpn and iv antibiotics or do nurses come to your home? Are your abscesses all perianal or intestinal as well? just wondering cos your story is soooo similar to mine.
 
No, I am doing TPN at home, and taking oral antibiotics instead of IV for now. I go to a home health care center once a week to get my dressings changed and blood drawn, they deliver my TPN supplies to my home once or twice a week as well. As far as I know, all my fistulas were perianal, until recently. After having so many procedures and not getting any relief for whatever is in my right cheek, I asked if I could have an MRI... The MRI showed a fistula coming from my intestines going into my pelvic region, but upon being admitted to the hospital, they conducted several CT Scans, which showed nothing. My doctor called it an 'anomaly' but then again, my doctor isn't exactly the brightest bulb in the tanning bed. Just hoping to get some real answers at my evaluation in Chicago next week... I can't take this unexplainable pain and having no idea what's going on inside of me any longer.

Annawato- for your sake, i truly hope your's isn't as similar to mine as you thought! if it is... well, i feel your pain!
 
Aussie said:
Hi Smallfry, if you're getting a lot of abscesses that aren't being driven by poorly healing perianal fistulae, it might be worth seeing a skin specialist to exclude a condition called Hidradenitis Suppurativa, can be commonly mistaken for perianal Crohn's.

Best wishes.
Click to expand...

Thx Aussie,
I'm not sure that's what it is but I will keep it in mind for sure. If all I had was abscessing then maybe I would be more inclined to think it was. But all the years of D, nausea, and scopes stating it's crohn's colitis makes me lean towards the crohns being the culprit. I see my GP and GI next week so I will feel them out. Thx! and best wishes to you as well.
 
Hidradenitis is also seen in association with Crohn's, so I'm sure you have Crohn's, although long standing Hidradenitis can get quite severe and resemble nasty Perianal Crohns that is resistant to usual treatments. When it gets really bad, it may need surgical excision, usually by a plastic surgeon.
 
Hello to all:

I have been lurking the forum for a few months now, ever since i had what i found out to be a perianal abscess drained in the ER in August 2012. I was hoping it wouldn't turn into this dreaded "fistula" i kept hearing about, but eventually after a few more weeks of persistent pus drainage, it was a fistula per my CR surgeon.

I was diagnosed with Crohn's after being hospitalized for a bad and long episode of bloody diarrhea in early July. Still dont know if the abscess/ fistula started due to an anal fissure i developed during the frequent and furious diarrhea and that fissure got infected, or if just plain ol' perianal Crohn's disease got me. Though, it is likely to be the Perianal Crohn's simply because my colonoscopy showed Crohn's in the colon only, and the extra-intestinal affects of that kind of Crohn's are usually manifested in the perianal region.

I have been to the CR surgeon's office 3 times since the first abscess drainage procedure in August. Each of those times it has been to have another incision and drainage done over the last incision because the skin kept healing over about every 2-3 weeks and creating another painful abscess. My CR Surgeon didn't operate right from the begining because he said my fistula seemed superficial (not involving too much sphincter muscle) and perhaps we should give my body a little time to see if it can heal the fistula on it's own. I wasn't prescribed any antibiotics either.

Since then i have noticed a definite trend in my fistula's ways. It seems that whenever i have a BM (normal or diarrhea) i get a swelling that developes in the fistula tract and the skin around the incision hole gets swollen too. It feels just like an abscess again: painful to walk, painful to contract the sphincter muscle; and the only thing that brings any form of relief is a hot soaking. I assume that this swelling is caused by stool filling up into the tract when i am passing a BM over the inner hole of the fistula tract. It always takes about 1-2 hours for the swelling to push pus and stool fragments out through the outer incision hole and then all is well again. The pain is so much less, and i feel pretty good.

I am going in for an Exam Under Surgery (EUA) with my CR surgeon on Oct 4th. He said that he will most likely be inserting a non-cutting seton so that the holes of the fistula tract don't continue to close up and allow the pus to painfully abscess or swell up inside the fistula tract when the skin closes over every few weeks. I am assuming that i am not a good candidate for a fistulotomy right now because my infected anal gland that started this whole thing is obviously not finished drainging ye, and might not be for quite some time. I am ok with the idea of a seton staying in for as long as it needs to - as long as that means that i wont be in pain for 2 hours after each and every bowel movement anymore.

Can anyone else tell me if their fistula operates with the same pattern of [BM- then swelling- then pain- then release after a few hours- then fine until next BM]? If your fistula has a different pattern, then please share that with me. Also, if anoyne has a non-cutting seton in place please let me know how it was for you after surgery and if the tract ever gets swollen or painful even with the seton in, and when does a non-cutting seton come out? Does it ever come out for someone who exhibits perianal Crohn's disease?

I am curious about what others are going through since i feel so alone in this. NO BODY understands. I don't have a single person i know that can relate to this... Thanks for any of your replies!

Lil Beak
 
Hi Lil Beak,
Sorry you are having to deal with these things. I wouldn't wish an abscess on my worst enemy.

To answer your question, yes- I do have an abscess/fistula which acts exactly the way you described. I have multiple perianal abscesses which still have setons in place and are still draining... a lot. But, all this time, the main source of pain has been deep in my right cheek, and even after 5 or 6 surgeries my doctor could not find anything in that area. I finally had to demand an MRI, which did show the fistula, but both my GI and Colorectal Surgeon told me it was inoperable.

I've been seeking second opinions on the matter because I can't have the Stem Cell Transplant until all my abscesses/fistulas are no longer infected. Saw the GI specialist at Northwestern in Chicago and he conducted a special "Fistula MRI", and referred me to another Colorectal Surgeon there. Unfortunately the earliest he can see me is November 9th. Oh well, after a year of being in unbearable pain, not being able to sit, and being on pain meds, what's another two months? :(

As far as Setons go, the doc said mine will be in for the foreseeable future. And that's fine with me, they really don't bother me, and if it keeps me from having any more pain in my butt then they can put as many setons in there as they want!!
And I've almost had immediate relief after having an abscess drained and seton placed (this time being the exception since there is a deep tissue abscess).

If you can remember, when you go in for surgery, ask for a "peri bottle"- it's a squirt bottle for your bottom. They give it to women after childbirth but it works great for butt surgery too! After every go, squirt the area first. Then dab or blot, never wipe! Get good quality toilet paper, some people like baby wipes, I've found they burn like hell but that's just me. And take as many hot epsom salt baths a day as you can manage.

Hope you get to feeling better and feel free to send me a private message if you have any questions or just want to chat! It does suck feeling so alone with all this, and no one, especially the doctors, seem to understand how EXTREMELY painful these things are!! I would rather go through childbirth every single day for the rest of my life than deal with the rectal pain associated with abscesses/fistulas!
 
Thanks so much AVW! You seem to be so strong, and your encouraging words and advice really mean a lot to me :) thank you.

Does anyone here with a non cutting seton in place have no significant pain anymore since the seton going in? I'm hoping someone can say that their seton was uncomplicated and turned out to be a blessing that has really helped them.

I would like to know, from those with a seton, if once the seton went in if it ever caused problems: like backing up of fluid in tract, discomfort while wearing certain pant materials, or pain during or right after a BM. Or if it just turned out to be a great help with no problems.

I'm hoping there are some encouraging experiences you all can share. I am in such pain after a BM everyday because the fistula tract swells up with fluid and stool each time. This leaves me unable to go on with a normal life for a good 2 hours while I soak and try to expel fluid from the tract. Then the tract releases fluid and it really feels better.

I don't mind having a seton as long as it means I won't have the BM pain anymore (since in theory it's job is to keep the fluid from clogging - which is really the only pain I have).

Thanks in advance everyone! I love the forum as a mental healing tool and I send good healing juju vibes to all :)
 
I have just had my first experience with a perianal abscess and saw the dr Monday he put me on cipro and flagyl and Tuesday it burst. It has stopped draining as of earlier today. Has anyone ever been diagnosed with an abscess and had not had it immediately drained, just relied on antibiotics alone? I am terrified of it filling back up again. Right before it burst it was smaller than a golf ball but bigger than a large cherry and the swelling around it covered an area the size of a large egg. I am taking sitz baths when I can and rinsing with saline solution every time I go to the bathroom. Any thoughts would be appreciated.
 
Sarah Bee said:
I have just had my first experience with a perianal abscess and saw the dr Monday he put me on cipro and flagyl and Tuesday it burst. It has stopped draining as of earlier today. Has anyone ever been diagnosed with an abscess and had not had it immediately drained, just relied on antibiotics alone? I am terrified of it filling back up again. Right before it burst it was smaller than a golf ball but bigger than a large cherry and the swelling around it covered an area the size of a large egg. I am taking sitz baths when I can and rinsing with saline solution every time I go to the bathroom. Any thoughts would be appreciated.
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Hi Sarah Bee-

In July this year i got my very first anal abscess. I went to the Dr. and they had me do a pelvic CT scan to be sure that the swollen lump on my anus really was a collection of pus/ an abscess and not something else. I had been diagnosed with Crohn's not too long before this, so it was likely to the doctors that this was a Crohn's complicational abscess. Not uncommon in Crohn's of the colon (which i have).

Well It was an abscess, and the scan showed it to be only 16mm large, like the size of a bean. The dr. consulted with a general surgeon, and together they agreed that the collection was small and that antibiotics alone would clear it up. I was started on a Flagyl course, and 3 days into it the pain had really gone away and the swelling seemed to get better. Then about 7 days in to it the swelling raged and got very painful very fast. The swelling just looked angry and red, it was very tender and grew to about the size of a small bouncy ball. I didn't know why it got crazy like that out of nowhere, so i went back to the Dr. She had me see a gen surgeon in the ER to make an incision in the abscess and drain it's contents.

At that time they had me start another 2 week course of flagyl and things were draining ok and feeling better for the next few weeks. But then after 3 weeks the incision they made in the abscess was starting to close up and heal over, but this became a problem for me because the abscess was not done draining yet. I was back in pain and a swelling had reformed. I went to a Colo-rectal surgeon who diagnosed the persistently draining abscess as an anal fistula.

That was 3 months ago. Since then i have not had to continue on any antibiotics, but i have had to get an incision re-opened every 3 weeks since then because the skin kept closing over. Finally the surgeon said it was likely not going to stop draining for a while, so i had a surgery to insert a seton into the fistula tract last week.

The purpose of the seton is to keep the tract open so that the skin cannot close up or heal back together where the incision is - allowing the abscess to continue to drain for as long as it needs to.

I have had a FANTASTIC experience with the seton so far!:thumleft: It has been the answer to all my problems with this abscess/ fistula lately. I dont have pain during bowel movements anymore, no re-abscessing/ pain at my anus, and it doesn't interfere with anything i do. I don't even feel it or know it's there unless i touch it.

Let me know if you have any other questions for me :)

Rebecca
 
Thank you Rebecca. I managed to get the abscess to open again today by taking sitz baths all night and keeping saline soaked gauze on it. It was draining this morning but I just went to the bathroom and checked the gauze and it has stopped again. I still feel a hardness there and a sharp pain with pressure. My dr got back to me and said if it is still hard on Monday he will see me then. I just don't want to be in pain all weekend if fills back up like earlier this week. I just want to make sure this drains properly.
 
Sarah, in my experience you should be able to encourage draining by exerting some pressure down there. I have found that when I would lay flat, or just stand still, and clench my butt cheeks as hard as possible several times it would get the draining going and really relieved pain. I just know it always did the trick for me.

It was funny how I discovered this technique.i was getting a facial and while she was extracting some white heads with that little tool, I kept having to clench my butt because it kind of hurt and i so was bracing during the pain, well i felt a rush of fluid down there and put 2 and 2 together. Lol
 
I did that literally anytime. I mean, no one can tell you are doing it! Lol. For some reason I always noticed that the abscess hole wouldn't drain after a sitz bath. It was like the water was blocking things up for a while. I would always have to wait about an hour after a sitz bath for anything to drain. So I never understood how people used sitz bath to get drainage to occur.

And no problem, I am so happy to help anyone her in any way. So many people here helped me when I needed it :)
 
I think the purpose of the bath is to soften things up so when you do apply pressure it's more likely to allow drainage. When I took the baths I don't find it does much either but then it seems easier to help the drainage if I squeeze it or apply pressure afterwards. It's like a blister. When it's all squishy you can squeeze it but when it's hard it's a lot harder to get anything from it.

I'm dealing with one now that seems to drain for a bit then it will stop and build up again and be sore until it releases
 
Hi there. One year ago i had a perianal abscess, i had surgery to have it removed, it was very painful at the time and a few months after it returned my doctor put me on two different antibiotics which didnt work. I had been to a conference that week on healing oils of the bible and learnt that frankinsence is so powerful and can be used to treat abscesses. I applyed a few drops onto a sanatary pad every few hours, i did feel a burning sensation but thankfully after four days i was gone, since that time it has flared up and i have put a drop of frankinsense directly onto the area. I would not recommend that for children but perhaps to put a few drops on the feet or ear lobe. Google frankinsense for further info. I was pretty sceptical and my doctor certainly was she wanted to admit me to hospital again but i insisted i try frankinsence (i have a huge fear of hospitals) thank god for this amazing and powerful oil.
 
My 15 year old daughter presented with perianal fistulas as first symptom of Crohns.Misdiagnosed by three doctors before ped GI made the call. In and out of the hosp. numerous times for TPN, antibiotics, Remicade, drainage, packing, repacking. Finally went to large teaching hospital where they placed two Setons. Thought coast was clear and 8 days after Remicade tx (added Methotrexate this time) having same abscess pain. Not a lot of pus though. Should the abscess still be forming with Setons in ? Still on Flagyl, Cipro, Entocort. Worried about being on Flagyl so long. Also, do you all think the Remicade is working or do you think it is working too well and healing outside inward too quickly and not allowing drainage ? Lastly, should we be moving the Setons around some? Dr didn't tell us to, but I have seen some people post to do so. Please help. Exasperated to say the least.
 
pipmom said:
My 15 year old daughter presented with perianal fistulas as first symptom of Crohns.Misdiagnosed by three doctors before ped GI made the call. In and out of the hosp. numerous times for TPN, antibiotics, Remicade, drainage, packing, repacking. Finally went to large teaching hospital where they placed two Setons. Thought coast was clear and 8 days after Remicade tx (added Methotrexate this time) having same abscess pain. Not a lot of pus though. Should the abscess still be forming with Setons in ? Still on Flagyl, Cipro, Entocort. Worried about being on Flagyl so long. Also, do you all think the Remicade is working or do you think it is working too well and healing outside inward too quickly and not allowing drainage ? Lastly, should we be moving the Setons around some? Dr didn't tell us to, but I have seen some people post to do so. Please help. Exasperated to say the least.
Click to expand...

This was my first symptom too. Took 7 years to get a diagnosis.

The idea is that the fistulas shouldn't abscess with setons in place, though mine kept swelling while I had setons in place to the point where it became painful to sit, so my GP called my surgeon who recommended flagyl. I didn't have a GI doc at the time because I was told I didn't have Crohn's by a previous GI doc in a previous city. The flagyl helped.

Pain could also be caused by the knot of the seton getting stuck in the fistula, in which case you would have to try to move it. I never touched mine unless the knot was stuck or the end was digging into my skin.
 
Somewhat good news today. Took my 15 yr old to Vandy for exam under anesthesia for butt pain. Remicade/Methotrexate seem to be working. Dr found non healing angry small pocket around Seton but no pus. He made small incision and packed with me doing repacking twice a day at home. Did remove one superficial Seton,but left the one involving sphincter. Hope she can begin to get her life back now considering this is her seventh surgery for perianal fistula. My older daughter also has disease and she made the trip to see her Colorectal surgeon. Not so good news. Scheduled bowel resection with temp ileostomy. This is such a horrible disease. Praying researchers will figure this out and provide better tx soon. Wish it were me instead of them. I'm sure I gave them their bad gene since they have different fathers. Also have a Jewish heritage. Scared for my third child who is male, GI said he has a 11-14% chance that he has it also,but didn't encourage testing unless symptomatic. Promethius test expensive and my insurance won't cover.Sorry for rambling, just exhausted and numb.
 
Oh Pip it must be so hard seeing your children go thru it all. At least we have only ourselves to think of whereas you have to worry about everyone but have no-one to worry about you. Make sure you look after yourself too. take care,
:heart: Anna
 
Anna, Sounds like you have been through so much and continue to battle with this crappy disease. I hope I can develop a more accepting and supportive attitude like you. I need to reach out more. Take care and God Bless.
 
yes, use this forum to reach out pipmom! Talking about things with others will help :) I have a temp ileostomy to rest my rectum from perianal abscessing/fistula with seton. Mine are all in my rectal vaginal septum to be more specific :( If you or your daughters need to chat feel free to message me!
Take Care,
Jen
 
Hi all. I'm brand new and so glad to have found this site! I'm also sorry for all that so much of you have experienced!

Here's my story--have had GI issues my whole life, diagnosed with IBS as a teen (early 30s now), Crohn's runs in family, but had a colonoscopy about 6 months ago that was normal. Doc seems to think just bad IBS--boughts of diarrhea/constipation, have to watch my diet extremely closely, abdominal cramping, history of hemorrhoids/fissures for 15+ years. Have had fissures off and on for years but have struggled mightily with it since Oct 2011. Several small abscesses formed in the last year that were healed with a Cipro/Flagyl combo, but the fissure itself hadn't healed since the colonoscopy in Sept (that of course retore it).

After unbearable pain and a lot of swelling earlier this week, saw my colo-rectal surgeon Wed who said I might have an abscess but she thought a thrombosed hemorrhoid. Sent me home with 7 more days of Cipro/Flagyl per my request. I knew it wasn't a thrombosed hemorrhoid--have had several and this was much larger and MUCH more painful. It was indeed an abscess that started draining on its own on Thursday. (It worried me a little that my colo-rectal surgeon misdiagnosed me, but I'm happy for her cautious approach of no cutting.) Has been draining for 4 days, I've been taking multiple baths a day, etc.

Here's my question--do any of you have any secrets as to not developing a fistula (assuming I don't currently have one)? I have read a high protein diet? I eat very little meat, so this will be something I need to work on. Also, were you on antibiotics while the abscess was draining? Will finish my course Tues and not sure if I need more--doc is a little hesitant to give them, and I understand. However, I was running fever with this earlier in the week (again, why the hemorrhoid diagnosis was odd to me) and just hope that 7 days is enough to clear the actual infection.

Thank you all for sharing your stories--it's VERY inspiring. I wish you all the best!
 
Cap13, I can't help with any of your questions though I am sure someone will be able to, but I just wanted to welcome to the forum. Theres a great bunch of people here who can give you lots of info.
:heart: anna
 
Thank you both so much!! I'm happy to have found this group of people! It's hard to discuss anal abscesses/fistulas/fissures, etc with coworkers and friends :).
 
Absolutely - I think their eyes would glaze over or more likely pop out of their heads as soon as you mention recto - vaginal fistulas. :)
Whereas we all go, oh yeah so and so had trouble with that etc etc.
Hope you get the answers to your questions soon.
:heart: anna
 
AVW,
It was interesting reading your posts. I too am in Lafayette Louisiana. I know what you mean when you say you haven't had much luck with the doctors. I think we are sortof limited on the amount of doctors here who even know anything about crohn's or understand the amount of pain those of us who have it suffer. I joined this forum today after reading the posts submitted by all these wonderful people. This looks like it is a great place for support, which is something we all need. Thanks to all who have posted here. It really helps to know others who have had similar circumstances and are willing to share their experiences with others. I'm happy to have found this forum!



:rosette1:
 
Welcome to the forum JKLT. And thankyou for your kind words. I'm sure you'll find lots of help here. don't be afraid to ask any questions no matter how minor or silly they sound. We're all here to help and support each other.
:heart: anna
 
Hi Guys,
I just joined this forum and found the information you have written very useful. Thanks for all the advise. Its been very useful.
Does anyone know how long an abbcess should take to heal from bottom up. I had a large abscess which was about 5cm deep incised and drained about 7.5 weeks ago and it is currently only about 1cm - intermittent discharging. It was a cavity but more of a tube shape. They were packing It initially for 2 weeks but then switched to using a Flaminal Forte Gel. They said initially about 1cm per week but this is obviously taking quite some time. Doing regular salt water baths but the whole is only very tiny now - but the bugger is not closed. Im worried there is a fitula of some sort somewhere around the area.

Im not sure what people think of the Flaminal But have found it easier then packing but unsure if this has had a detrimental affect on healing.

B
 
Hello. I broke a tooth, and was prescribed a powerful medication. Many DR visits and tests later, including blood, stool, CT Scan, and Colonoscopy all normal, my dr said it was all diet. It took me 2 years, but I determined it to be an anal abscess. The dr laughed, but checked anyways. Sure enough, there it was, golf ball size and fistula attached. It seems it may have been draining out between the tests, and they tell me the weight of it is the same as surrounding tissues, so no test could detect it. I turned down the surgery, and have survived with this condition about 3.5yrs now. I'll mention some healing tips at the end. If all of you suffered with an abscess, was it very foul smelling? I have lost all of my friends, my family has mostly disowned me, I have left one job already, and may eventually leave my current one. People 20-30ft away can complain. It seems its the pus or some kind of drainage that causes the odor. I havent found any proof an anal abscess can be removed without loss of continence, so if I continue to leak I will continue to smell. Has anyone else here experienced this problem? I tell people I have a serious condition but they still hate and fear the heck out of me, like they may catch something. Wondering if there is a way to bring the smell down.

Top things that have helped me, I'll recommend exercise. Not the treadmill type, its a waste of time. I do a full powerlifting routine, but at a reduced weight from before this incident. I credit the weightlifting for keeping me alive, as I lost 20pct bodyweight when this first hit.

I found a medication that has an extra benefit. My dr sent me to a colon surgeon, and he said I had a fissure. He recommended sphincterotomy. I researched that, and a test of 300 people had 45% saying they lost all continence within 10yrs. Not the solution. I found this heart medication, reading the wiki on it will show what it can do. Its called Dilitizem. This is the end of my first month of it, altho my dr nearly declined getting it for me.

Next thing I did, which almost immediately got me results, was quit using toilet paper. I use baby wipes and wash off, and sitting isnt so bad anymore.

Anyone that can help with the smell problem, either by relating or offering a solution, I will be greatful. I have concluded either the abscess and its drainage stink, or I have an internal digestional disease to go along with this. My best guess would be Candidisis, look at the side effect list for that. I am also curious about Clostrodium Difficile, which I tested negative for twice at my own request.

Good luck to all of you. I am tired of being the Reject, the Enemy. I first got this at 29, was in great health with a potential future ahead of me. Im mid 30s now, and it seems this disease is a life sentence, lonliness and hatred included.
 
God Avw so sorry u r going thru all that u r so young, unless that pic is 20 years old lol kidding. Been up all night researching after 8 hours in er and dx with anal abscess. never had anything like this its awful. they sent me home on flagyl and cipro and gave me iv antibiotics in hospital. just looked and its so inflamed. I kind of self dx before er visit cause of pain fever and night sweats last too nights. they gave me a number for a surgeon to call tomorrow. im 40 and this sucks and need advise on what to do next. they did not drain it and it surely looks worse then before er trip. HELP! mind you I am a baby with any kind of illness i just want my mommy lol. THANK GOD FOR THIS BOARD.
 
Hi HotToddy
Sorry to read about your anal abscess. I've been there where you have several times. At present I have two setons in place and three complex fistulae - I don't mean to freak you out it's just that my perianal disease is very proactive!

To me the the doctors always prescribe antibiotics as the first line of defence for perianal abscesses. Thereafter if it doesn't have the desired effect i.e. reducing the swelling/inflammation the colorectal doctors then look at draining it. It's so annoying to have to go through all the suffering and pain in the interim. Hang in there though hopefully you can have it drained soon and thereafter be on the road to recovery.

All the best... just so you know there are plenty of times when I also say: "I want my mommy!"
 
2 years ago I had a sore just outside my anus... it wouldn't heal. My ObGyn took a look, prescribed antibiotics and everything has been fine until early May this year... the area inflamed and was big and tight and painful for 2 days until I took ibuprofen and the swelling went down, however, it has pussed a little almost every day since. The pus has little to no odor. I'm also experiencing bits of gas? escaping from my anus. not like a typical fart, just feels like bubbles.

some history... I've had a fissure probably my whole life and hemorrhoids - both flare at times but I've gotten used to them and typically don't have issue or notice those.

so the wound, which I believe is an abscess, has leaked a little almost daily and my rectum is often achy... I have a holistic care provider who has offered homeopathic remedies with some relief but not an end in the condition.

7/22/13 i went to a clinic for an exam... they did a digital and I guess a super short scope? Dr said "I don't see anything alarming, no need to cut anywhere." He put me on both an oral and a rectal antibiotic for 2 weeks which I took correctly. The only change in the wounds activity was fresh red blood on tissue sometimes - which I had not been seeing and I have not been able to see if blood is from the wound or the anus. *you get pretty good squatting over a mirror with a flashlight with this condition. lol

Speaking of mirror squatting... I've noticed the last couple days it seems a lot of the glands around my anus might be "leaking" a little bit of fluid. does that sounds right?

8/26/13 I returned to the clinic for follow up... I reported, "little to no change" Doctor looked at my butt... he did not do a digital or scope - he sort of spread my cheeks and pushed around saying "I don't see anything"
I had to say "see that small, slightly swollen spot to the left of my anus?" yes "ok, see that little dark dot in the middle?" yes "sometimes stuff comes out of there" he told me to get dressed and we'd schedule an exam under anesthesia and possible fistulotomy, possible seton.

I immediately panicked. I do not want this surgical exam, definitely don't want fistulotomy or seton... I don't want to wake up finding out I've been cut or need ass packing on the daily. I've read a lot these procedures are not perfect outcomes and that a lot of follow up is necessary and reoccurence is common!?!?
I am a business owner stuck at work or my business is closed which could result in losing business.

I'm looking for options to healing this condition with natural remedies, food etc. I'm looking for any recommendations to manage this condition and heal it without surgical intervention. I'm not too happy they couldn't confirm more about my condition before surgery.

Any suggestions for natural options are welcomed and appreciated. thanks!
 
The exam is done under sedation and is pretty painless. The seton placement - if it is just a seton placement - is generally not bad. I have been dealing with this for a few years now and have never had to deal with packing beyond the first day. I think it is all related to the size of the abscess. Sounds like yours is tiny... there are people on the forum you have ended up with ones the size of a tennis ball.

Heat is always helpful to keep it draining and frankly is the only natural solution I have ever found. Sitz baths with or without epsom salts and heating pads.

The seton will just keep it draining - if they find a fistula, It is basically just a string that runs through it in a loop and when they are confident it will either heal or at least not cause a big abscess they will remove it. If you don't take care of this thing it can go from missing a couple days of work to a couple weeks of work with time in the hospital and daily packing.

You talk about your doctor but don't mention what kind of doctor. I am guessing a Colorectal Surgeon? Don't let anyone else touch the thing.
 
I ditto Sailorluna! My son just had his 5th surgery for a peri-rectal abscess yesterday. The first four were done by a pediatric surgeon our at our wonderful children's hospital but he really shouldn't have been doing anything. We had to wait 3 months to see an adult colorectal surgeon who treats kids. The first surgeon never really found a fistula. He drained, he put a seton through something that wasn't a fistula and created a larger abscess, he overpacked it and my son was admitted for several days, he then put in a penrose drain that finally gave him relief but a couple months later, it worsened.

This doctor saw him once, scheduled the exam under anaesthesia for yesterday and found 2 fistulas...1 just under the skin and one below it that was deeper but only went through a very small amount of the external sphincter muscle. He saw no abnormal tissue or signs of Crohns in the rectum (his disease has remained in the terminal ileum thus far) and he performed a fistulotomy yesterday. He also "took the roof off" the long term abscess to allow that to finally heal now that it is no longer being fed by 2 fistulas. He used hydrogen peroxide to detect any more fistulas and was 99.5% sure this was it.

I am trying not to focus on this but his life would have been SO MUCH different if we went to this doctor months ago! He would also have much less scarring when this is all said and done.

I EMPLORE anyone going through this to take a little extra time and find a great colorectal surgeon. It is a MUST with this!!! If you need a quick incision and drainage to manage pain short term, do that but don't let them do anything else to you until you see a colorectal surgeon!!!

He looked at me after the surgery sternly in the eyes and said, "If anything like this ever happens again, you must bring him to me!" Of course, I already knew that! Every nurse, anesthesiologist and employee at the surgery center pulled me aside prior to surgery to tell me we have the best doctor and he would be there doctor if they ever needed anything done. That helped me get through the morning. We knew seton placement was also a possibility depending on the location of the fistula. By the way, my son had 2 MRI's that showed no fistulas.

All my best to all of you. We are ready to manage his postop course and pray this is it for a very long time!
 
Oh - sorry inpain..... there really are no natural cures for this. One thing you can try is hyperbaric oxygen if you can get it paid for. That does have some promising results. Whether you try meds like remicade, HBO2 or other means... you need the infection under control and therefore surgical support is really needed whether it be a seton placement or a fistulotomy. They will only do the more curative fistulotomy if you have no active disease in the sigmoid or rectum. If there is, it won't heal. All research shows better results for fistula healing with seton placement during treatment with meds. It will also allow you to live a more pain free existence in the meantime. We were resistant to all of this at first as well. After living with this for 7 months, you become very willing to try things that once seemed unimaginable.

Having a fistulotomy is more common than any of us think. We learned we have two friends without Crohns who had this done. It is just not stuff people talk about...unless they have Crohns and UC!!!
 
I'm sory to hear about your'e situation. I too suffer from the abscesses since June 2013. At first I did not know what to think, but I as researched I became aware. I told my doctor about them at my August visit, and he prescribed antibiotics ciproflaxin and flagyl. Within a few days the abscesses were gone. I used all the antibiotics, and a few days ago, I had another abscess in the same place. So, I'm back on the antibotics.
 
Antibiotics do work for some people as a more permanent fix but generally it only keeps them away temporarily and can be a good bridge treatment until you find something that is more effective long term.

My son is doing great since his fistulotomy and debridement of the undermined skin beneath after 7 months of abscessing coming and going. He has had 15 hyperbaric oxygen treatment and his wound is almost healed 3 weeks after surgery. The area was about 1/3 inch deep, 2.5"' x 1" wide. It is amazing how quickly it is healing.

Best of luck to all of you. It is a long road. The success with hyperbaric oxygen for perianal crohns is higher than most therapies and the remission is high as well after treatment is complete. I really hope it is an approved treatment someday.
 
The only times ive had relief from Fistulas and abscess was 1. when I was on Remicade completely healed and was in remission for 8 years. Then it quit working. 2. last year I had a temporary colostomy for 8 months to allow my rectum to heal. Surgeon said it looked like swiss cheese and they removed 6 inches. I currently have a seton placed and it still drains and hurts but no abscess at the moment. Been on many rounds of anti biotics but they dont work for me anymore. Good luck and god bless to all
 
I've just had a fistulotomy and seton inserted on Monday after doing the antibiotic thing. The antibiotics helped but the abscess came back soon after I stopped them. I developed these whilst having an ileostomy which is really unfair!!!! Hopefully the op will resolve things, I'll let you all know how it goes.
Anal abscesses I've had in the past have healed with just lancing so not sure why they didn't heal this time.
 
Hi Lil Beak. I had a seton inserted 4 days ago because of anal fissure and abscess and fistula that had two tracks. One of the fistulas was laid open which I think is a fistulotomy and the other had the seton inserted. I had very little pain post op although I am on painkillers all the time so maybe they helped. I didn't need any more.
since the op it has been draining a bit of pus and blood but not too much - maybe they cleaned it out whilst I was under.
I have a stoma so thankfully don't have to deal with the pain of passing poop, just the occasional mucus poop. So my symptoms were different to yours. I had a little pain from the fissure and when the abscess closed over and grew it was very painful - a deep ache in the rectum. Otherwise I just had blood and pus draining. I was initially put on cipro which cleared up the infection but it returned pretty quickly.
Other abscesses I've had were incised and cleared up on their own.
I hope you get yours sorted out soon. Don't be afraid of the surgery as it is not as painful as I expected it to be.
:heart: anna
 
Thanks Jen, thats a great blog with some handy hints for everyone suffering from draining fistulas and perinanal abscesses.
:heart: anna
 
I have had a perirectal abscess since 2011. It has been a painful and hard couple of years. I had two surgeries in 2011, a third surgery in 2012 and just recently a fourth surgery that failed because a major infection. I had a seton that was placed during the second surgery in 2011 and was removed the summer of 2012. Shortly after it was removed I had to have the third surgery to place a new seton. The surgery that just failed was to remove the seton and to place a fistula plug, and to close the incisions that are on either side of my rectum. I am still really bummed that the surgery didn't work especially because I was told that I'm in clinical remission, but the surgeon and I are hoping to try again in a few weeks. I am just curious if anyone has had a fistula plug, and if you have was it successful?
 
I have not had a fistula plug but have heard they can be successful but I heard from my son's surgeon there is about a 30-40% failure rate. He went on to say that with repeated tries, they generally end up working. I also read about doing a fistula plug with an advancement flap (if you are a candidate for that). This can be a bit more successful in some studies. Let us know how you do. As a mom of a kid with 5 surgeries under his belt, I know the frustration with all of this!
 
I am able to do the advancement flap that was part of the surgery plan, along with the fistula plug. I seem to heal well I just cant seem to shake this infection. I'm allergic to flagyl which is always that antibiotic they want to put me on to fix the infection. Surgeries are always the hardest part, luckily I have a great husband that supports me through it all! I hope that your son is doing well!
 
MikeinBklyn said:
Sorry to hear about your son, I know his pain.

The only thing that closed the fistula, after the "laying open" surgery was going on Humira every ten days. The fistula closed in two days.

In Crohn's patients usually abscesses come from fistulas that tunnel and create a pocket, hence an abscess.

Good Luck and tell him to keep a positive attitude!
Click to expand...

I developed an area of complex/communicating fistulae while on biologics. :ybatty: My first appt, after discovering this via MRI, is the middle of Oct.
 
Thanks. We thought we may have to do the plug but his fistula was simple and superficial so we were able to do a fistulotomy. He is unusual in that his tissue in the colon and rectum shows no signs of Crohn's. He has it in the terminal ileum only. His surgeon who is very experienced is hopeful that he may not be prone to this in the future but time will tell. He and the other surgeon were both surprised to see how healthy and inflammation free his tissue is in that region. Unfortunately the pediatric general surgeon who does do a lot of IBD related surgery was not experienced with perianal issues. Once we went to an adult colorectal surgeon, the fistula was finally found and we got lucky since it didn't go through any muscle.

If any return, we may consider biologics. There is just added risk of other issues such as cancer in young males so we would like to put it off or avoid it if at all possible. Time will tell. He is on pentasa and methotrexate for now. He also had 20 hyperbaric oxygen treatments after surgery to aide in the healing.

I sure hope you can get control of your fistulas since they came back on biologics. Google about hyperbaric oxygen for perianal disease. It shows a lot of promise!!!
 
I did take a look at the hyperbaric oxygen, I think that I will bring that up to my GI and surgeon. I also have no signs of crohn's in my rectum and I only test positive for it in my terminal ileum. My fistula has unfortunately gone through muscle and is deep. It is nice to hear that your son had such a good out come! It helps to hear positive stories! Thanks so much for the information I really appreciate it!
 
My son's HBO2 was covered because he had a chronic wound. It is not usually covered for Crohns itself. If you get a doctor to order it, suggest it is worded under codes approved for your insurance. You can get that info from your insurance. You can generally find it online. Then ask the doctor to word it in that fashion. Hospital based units are very costly but worth it if it is covered. If it wasn't covered, we were going to use a single unit that was $175 per treatment. My son had 2 HBO2 board certified doctors that ran his therapy. Up to 11 people could fit in the unit. The doctors said that if you don't see any benefit in 10 sessions, it will likely not help. If you do see benefit, 20 - 60 sessions as long as there is improvement is what you often need for Crohns related fistulas. His sessions were 2 hours. 10-15 to pressurize the cabin, three 30 minute sessions with O2 masks on and 5 min breaks in-between. Then 10 minutes to de-pressurize. He would read, do homework or sleep in his unit. Many of the people in there had wounds from diabetes, carbon monoxide poisoning, brain tumors and some had oral surgeries. It truly was fascinating.

If he had a seton instead of the fistula, I imagine he would have had more than 20 treatments.

Let me know how it goes for you all.
 
Hi, I'm brand new here even though I've had CD for 25 yrs. My first problemwith CD aside from severe d, pain, weight loss, ect was from a peria abscess. It was drained in emergency with local anaesthetics. It was sooo painful I fainted. It was too severe to heal on its own so I had to have surgery for it. From what I can recall, I was put on cipro had a nurse come in to pack it regularly, was given a peri-bottle and had to take sits baths after each BM. I think I was back to work within a month and it never came back. I was however in remission for a number of years up until 5 yrs ago. Last year, I was convinced something was up and sure enough I has a peria fis which cleared up well w Remicade. I really feel for anyone living with this and thank my lucky stars I haven't had to put up w this again.
 
Hi BoyMama2000,

I am so happy for you that your son is doing great! I am in very bad shape now and basically my doctor here tells me they can not find the inner opening of the fistula and that is why even after 17 procedures i still have recurrences. I was told if I want to have any relieve from the fistula/abscess, i need to have my anus and rectum removed and wearing the bag. I would really want to try your son's dr before the surgery. Really really appreciate it you could let me know the name. I have also send you a private message. you could let me know by sending me a private message if you want. thank you so much!
June
 
June, I am very sorry to learn about your suffering. Before deciding on going with a radical surgery like ileostomy, why not learn about the treatment that I underwent? I have posted my story here - https://fistulapatient2patient.wordpress.com/

At the least, you can have it checked by Dr. Bhat before you decide to pursue treatment with him. In doing so, you have very little to lose.
 
glum chump said:
Protein is a good healing agent---meat, fish, eggs are all low fibre options for boosting protein.

I wish I had an answer for your question about how to permanently stop abscesses from occurring, Allicat. I've had them for many many years, but I've never had any medical intervention. The minute I feel one coming on, I call my GI straight away and he puts me on antibiotics. The symptoms that trigger me to assume I've got a fistula or abscess happening are: high temperature, chills, night sweats, lack of appetite, etc. I figure that even if it's not an abscess or fistula, the symptoms indicate some kind of infection, so a 2-3 week course of antibiotics wouldn't be the end of the world, regardless.

When I can feel it on the outside of my anus, I begin to hot compress it several times a day for at least 10 minutes each time (soaking in a hot bath would be helpful as well). Keep the water as hot as possible. Within a few days, the abscess 'breaks' and the puss and other stuff starts to drain out of the abscess. I continue to hot compress until the pain subsides and I can begin sitting again, which is usually quite soon after the abscess breaks.

Don't know if this is helpful for your son or not---abscesses are horrendous and they sure do knock the stuffing out of a person.

I wish him well in his recovery.

Take care,

Kismet
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Question if you don't mind I just had an abscess a couple months ago it was taken care of but now I have a second one it was kinda bumpy and filled with pus but the same thing happened I do the same thing you mentioned the sitz bath for 10-15 minutes and it broke open should I be worried that it opened or is that normal ?
 
Open is normal as you want it to drain completely out. I would keep doing sitz baths, Epsom salts also help to draw the stuff out. Keep area clean and dry in between baths. I hope it doesn't become a fistula, tough to heal. May want to consider antibiotics in the sitz bath or oral
 
stretch said:
Its difficult to give advice because everyone is different. But I have been abscess free for about 8 years and the complex fistula (that took 7 years to heal via about 5 EUA's and the same amount of seton drains) disappeared about a year ago.

The seton drain was the only route for me as it gave the best chance for it to heal up and I didn't need to take metronidazole and more (which made me feel ill) plus we all take enough tablets already for our condition.
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How do you get rid of complex fistulae with a seton? I have them all along my anus and in sphincter muscles.
 
allicat1214 said:
It seems like so many threads that discuss abscesses indicate they come back....Has anyone actually had an abscess actually heal after just one occurrence? If so, what is your secret??

My son who was diagnosed with Crohn's last summer, developed a perianal abscess that was drained in the ER on July 4th. He came for follow-up this past Monday and surgeon said it had to be re-done in OR under general anesthesia. That happened on Tues, he's been in hospital since then. They dug out major tissue....all indications are no fistula, but abscess went right up to rectum. No signs of crohn's in rectum...but anus was sore and raw from procedure when they did a little biopsy to determine if crohns.

They were giving him Zosyn & vancomycin IV, nothing extra for Crohn's just his 9 mg of entocort and pentasa.

They gave him miralax to avoid hardened stools with pain meds he was on, but that seemed to cause major D in hospital. I asked two nurses and a doc whether he should still be taking miralax since he had several bouts of D a few hours after taking it. Colorectal surgeon said he had to stay on it to avoid hurting abscess, but finally spoke with the GI docs and they said yes, take him off!!! Thank God!

So he is going home today with percoset for pain to be used when packing is changed daily and augmentin. They are setting up Home Health to come out daily to change packing. Thank God for that, too! ER had me try to do it with initial drain and he almost fainted when I tried it!

Besides Zinc, Vitamins A, C & E, probiotics, what else can I give him to expedite healing and prevent recurrence of abscess? He goes back to college in a month!!

Thanks in advance!
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My advice, stop letting local surgeons continue cutting, if results aren't worth it.

I had to relocate to Pennsylvania, to be near John Hopkins hospital, from my home in the South on the Gulfcoast, cuz my doctors down there simply aren't smart enuff to deal with the degree of severity my Crohns disease is, and due to its severity, Hopkins doctors took my case on, despite being so far away at that time.. Unfortunately I didn't know then what i know not, so I didn't get away before they basically butchered me first, and now a Fistula that was supposed to have been removed in 2006, is still there and has attached to scar tissue internally, causing an abscess as well as Extra-intestinal Fistula. It's spread from the back side, perianal area, alongside my inner thigh, till it's now reached the pelvic bone and Genital region, causing me a WHOLE BUNCH of new problems that I had NO IDEA Crohns could cause, and pain on a whole new level.

My sex life is now indefinitely on hold, and the surgery to go in and remove scar tissue, abscess, and Fistula, could itself cause erectile dysfunction.., and that will be the proverbial 'straw that breaks the camel's back'..

I wish I had better advice to give. The only advice I have tho, is make sure you've got the best surgeons possible.., and don't ever ignore your gut if it's telling you the surgeon feels unsure about the chances of a successful surgery..
 
I went to the ER at Mayo Clinic last year because of a painful abscess that eventually popped by itself the night before I went in. They wanted to do surgery and this and that, but I did it on my own and just stuck with a diet high in organic, cooked vegetables and other things. Yes, not kidding, they healed on their own within a week or so after I got out of the hospital. I didn't even take the antiboitics they prescribed me to take after I left there.

Follow a diet predominantly organic, cooked vegetables, with some animal protein. Include many different greens, 3-4 cans of sardines/ week (for omega 3s and vitamin D), a couple servings of lamb/ week (less hybridized than beef today), certain supplements to speed up renourishing/healing the body: digestive aids, kelp, TMG, zinc, magnesium.

I also drink 10-12 ounces of juiced organic carrot juice each day, with a nub of ginger root thrown in for added medicinal benefits and taste. Throw in a clove or two of garlic for an even better effect. Here's an example of what I eat, I like to start my morning with a pound or so of frozen sweet peas cooked, then get yourself some grass fed butter to put on it, with a raw pastured egg yolk or two, organic dried cilantro/parsley/dill mixed in with the peas, and baked collard/chard chips coated in olive oil, cumin powder, and garlic powder with Real Salt. Delicious way to start the day.

Take out all processed foods, try to cook every meal at home from scratch, and don't complicate the recipes. Mono meals are much easier to digest than a meal with 4 or more different veggies. Oh, and I think I remember drinking plenty of organic aloe vera juice (the Lakewood brand) during healing. My Natural Grocers actually had whole organic aloe vera leaf in stock, and I bought a few of those, and scooped out some of the gel with meals or ate it on its own! Very bitter, but very good for you, especially for Crohns.
 
Mr Palermo, your words are music to my ears. I had a fistula and 5 operations over the space of 15 months and then said enough. I ate vegetables just about all day every day for three months. At the end of it my seton finally fell out itself and the fistula was healed. That was five years ago and since then have been drinking vegetable juice practically every day and I've had no reoccurrence. I would love to hear more about your story. If you are interested please get in touch. PerianalAbscess.org. I should add, what worked for me may not work for everyone but good to know it worked for someone else too. thanks again.
 
Hi everyone. I was diagnosed with UC back in the 70's while a young teen. Over years, with diet and medication, I unsuccessfully controlled most of the pain and irregular BM's. Advance 20 years and I have to have major surgery for Meckel Diverticulum, where they remove the extended intestine, this is when I get the Crohn's diagnosis. 5 years later another flare up causes them to remove another blockage in the small intestine and my gall bladder. Repeat another 2 years later and then again 3 years later. I now have had 5 surgeries to remove blockage. A colonoscopy last July showed the Crohn's was in remission, but since then I have had what I thought to be hemorrhoids. Burning, itching and moist feeling around the anus. I tried to self medicate with Preperation H and warm baths, it helped and things seem to clear up, six weeks later, it returns with a vengeance. I cannot get the sensation of having just messed myself to go away. I go to my PC and they send me to a GI specialist. He tells me I have perianal abscess and to stop the Prep H. They do some blood work and informs me that the Crohn's is active once again. He is also suspicious that rectal cancer may be present, but those test results will not be back until next week. In the last week or so, the itching and wet sensation has increased. How do ya deal with all this at work? I have limited my social activities and stay home as much as possible. When out, I do the best I can to keep distance between me and others. What can I do so I don't feel "unclean"? Appreciate any suggestions.
 
toesaw said:
Hi everyone. I was diagnosed with UC back in the 70's while a young teen. Over years, with diet and medication, I unsuccessfully controlled most of the pain and irregular BM's. Advance 20 years and I have to have major surgery for Meckel Diverticulum, where they remove the extended intestine, this is when I get the Crohn's diagnosis. 5 years later another flare up causes them to remove another blockage in the small intestine and my gall bladder. Repeat another 2 years later and then again 3 years later. I now have had 5 surgeries to remove blockage. A colonoscopy last July showed the Crohn's was in remission, but since then I have had what I thought to be hemorrhoids. Burning, itching and moist feeling around the anus. I tried to self medicate with Preperation H and warm baths, it helped and things seem to clear up, six weeks later, it returns with a vengeance. I cannot get the sensation of having just messed myself to go away. I go to my PC and they send me to a GI specialist. He tells me I have perianal abscess and to stop the Prep H. They do some blood work and informs me that the Crohn's is active once again. He is also suspicious that rectal cancer may be present, but those test results will not be back until next week. In the last week or so, the itching and wet sensation has increased. How do ya deal with all this at work? I have limited my social activities and stay home as much as possible. When out, I do the best I can to keep distance between me and others. What can I do so I don't feel "unclean"? Appreciate any suggestions.
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Oh toesaw that's horrible :( all the best for your results. I'll keep my fingers crossed for you.

With regards to keeping clean when out and about, gauze between the bum cheeks to absorb any leakage, change this regularly, pad or panty liner in your underwear for extra protection if you have a lot of leakage and wet toilet wipes (not perfumed) or spray saline solution to keep the area clean when out and about.

I hope this helps.
 

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