fissures, what do they mean? and other questions

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poobah
Regular Member


Date Joined Dec 2006
Total Posts : 136
   Posted 4/21/2008 6:22 PM (GMT -7)   
does anyone here have fissures without or perianal disease? or do fissures imply its only a matter of time. . .
 
question#2, for how long have people found remicade or humira to be effective?
 
question#3, has anyone achieved remission with azathioprine? for how long?
 
 

potatoqwn
Regular Member


Date Joined Jan 2006
Total Posts : 355
   Posted 4/21/2008 7:05 PM (GMT -7)   
#1 Fissures mean pain, pain, pain! Oh, and bleeding.
#2 Going on two years with Humira and doing just fine.
#3 No, not for me.

nawlinscate
Veteran Member


Date Joined Jan 2007
Total Posts : 656
   Posted 4/21/2008 11:18 PM (GMT -7)   

A couple of years ago, I had--in this order--a perianal abscess, a perianal fistula, and a nasty fissure. I was totally panicked, since I thought this meant that my disease (which had always been confined to my terminal ileum) was spreading into my colon and rectum.

The colorectal surgeon told me that that wasn't the case at all. Turns out that there are plenty of mechanical reasons for all three of these things, including periods of very bad, irritating diarrhea that can cause an abscess, fistula, or fissure. I was really surprised when he explained to me that lots of people without IBD get all three of those things. (In fact, my husband, who doesn't have any chronic disease or conditions, had to have surgery on a very painful fissure last month.)

The surgeon lanced and treated the abscess, which disappeared. He was able to surgically repair the fistula. But nomatter what he tried, he was unable to get the fissure to heal--so I have it permanently now. Sometimes it gets irritated and really hurts (if there's been lots of watery diarrhea and straining); the rest of the time, it's mildly bothersome. But I can live with it, I guess because I have to.

Five years later, my CD is still confined to my terminal ileum. So a fissure doesn't necessarily mean that your disease is spreading.

 

 

 


poobah
Regular Member


Date Joined Dec 2006
Total Posts : 136
   Posted 4/22/2008 4:27 AM (GMT -7)   
unfortunately, ive already got colon disease, at least if the ct is to be believed. and i believe it because of the location of my pain.

i gues what im driving at is, do fissures herald more advanced perianal disease?

poobah
Regular Member


Date Joined Dec 2006
Total Posts : 136
   Posted 4/22/2008 4:28 AM (GMT -7)   
potatoqwn, did you have any luck with other meds before humira? where is your disease located?

potatoqwn
Regular Member


Date Joined Jan 2006
Total Posts : 355
   Posted 4/23/2008 10:24 PM (GMT -7)   
poobah, my Crohn's is located in my colon. When first diagnosed, it was in skipped areas throughout my colon, but most specifically in the lower 8 inches or so. I tried everything under the sun that can possibly be prescribed for Crohn's. I really never did have much help with any of them until Humira. I would get a tiny bit better with prednisone for brief moments of time. They didn't have Humira or Remicade when I first got Crohn's about 17 years ago.

The fissure I had was really wide and long. It hurt so much and I bled like crazy. The whole toilet bowl was completely red every time with every bowel movement. The fissure finally healed after about 2 or 3 years. So, I guess some meds did work after all. I also would live for months at a time on water and Ensure only to help ease things. I do know that the rectal meds were of some help, specifically with pain. I used Rowasa enema's for years. I also used Cortenema and Cortifoam. I liked the foam best because it did not have to be held all night.

Sorry you are going through this. I know how miserable it is. I hope things get better soon with you.

poobah
Regular Member


Date Joined Dec 2006
Total Posts : 136
   Posted 4/25/2008 7:39 PM (GMT -7)   
17 years? wowzer. its hard for me to imaginge going 17 years feeling like i do now..
 
do you have crohn's colitis only, or small bowel disease too?
 
ever have fistulas or abscesses, or just the single fissure?
 
how often did you have to take the steroids, and for how long during your flares?
 
did the 5 asa meds not help?
 

nursetiff
Regular Member


Date Joined Jul 2007
Total Posts : 33
   Posted 4/25/2008 8:25 PM (GMT -7)   
I had anal fissures and a small fistula that were healed within 3 months of Remicade and Imuran....now I'm in remission and am going to try to get off Remicade and be only on Pentasa. Most people have good closure of fissures/fistulas with these drugs. good luck...
diagnosed with Crohn's 2/2007. Small bowel resection 4/2007 d/t abcess, perforation.
Currently on Remicade, Pentasa 1000mg 3xday.


potatoqwn
Regular Member


Date Joined Jan 2006
Total Posts : 355
   Posted 4/26/2008 6:05 PM (GMT -7)   

Crohn's colitis only (I hope!)

No fistulas, one absess, and that one wide, long and deep fissure which lasted years.

I have taken steroids on and off over the years.  I will only take them again if absolutely, positively necessary.  The last time I was on them was about three years ago.  My flares were one long one that lasted about 15 years solid.  I never went into remission until Humira about two years ago. 

I used to take 12 Asacol tabs a day, but now I am down to 4.  At times they switched me to Pentasa and my dosage was 32 tabs a day.  It never really seemed to help things.  The Rowasa enemas would help a little and then pretty much stop working after a couple of weeks.   

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