Seton insertion

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DianaN
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Date Joined Jul 2008
Total Posts : 3
   Posted 7/14/2008 1:35 PM (GMT -7)   
Hello,
My husband had a seton stich insertion 2 days back.First day,he was fine,but now he is in terrible pain though he is taking few doses of pain killers..Is this pain natural?Or does this require immediate medical attention?
And one more question,his wound looks like a gun shot injury and its very scary..:( I haad a look at it,but couldnt see seton stich outside..Is it fine?I can just see a big hole,thats it..
 
Please help
 
Thanks,
 

Post Edited (DianaN) : 7/15/2008 3:42:24 AM (GMT-6)


mjoneh6
New Member


Date Joined Jul 2008
Total Posts : 3
   Posted 7/14/2008 2:41 PM (GMT -7)   
Is this the same as a seton ring, if so I had one fitted years ago and the treatment lasted 6 months or so, it was pretty uncomfortable at first and could be sore when moving or repositioning/sitting but i cannot remember being in agony for any length of time, you should never be wary of calling your doc, even if your man says not to!!!!, you know what us boys are like, big feardies.

dreamer06
Regular Member


Date Joined Jun 2008
Total Posts : 221
   Posted 7/14/2008 3:01 PM (GMT -7)   
I had setons put in and I was fine for the first few days then after that it started hurting. I still have to take pain killers every once in a while even though I had mine in a few weeks ago. I think some pain is normal, it is in a tender spot. But if it is really bad and pain killers arent working I would call the doc.

LavenderBlue
Regular Member


Date Joined Oct 2005
Total Posts : 168
   Posted 7/14/2008 3:42 PM (GMT -7)   
I had my seton removed a couple of months ago. I'm assuming it is for a fistula?? If so, I will say I was pretty uncomfortable starting the day after the procedure. Often if you have anesthesia it acts as a pain killer for the first day or so. I agree with the others, I wasn't in agony, but it was painful. Is the wound you're talking about a fistula? If so, yeah, it probably looks like a hole. Mine wasn't lovely, or in a lovely spot (girl area). though, come to think of it, every time the surgeon looks at it he thinks it looks great. why thank you! oh, he means the surgical healing. no, but really, it's probably normal looking if it's a fistula. but as for the pain, if its that bad, I agree, call the doc. That's what they are there for!
lavender
 
diagnosed: Crohn's Aug 2005
 
other set-backs: Vasculitis Aug 2006, Sub-total Colectomy (10 inches of colon left) Feb 2007, Ogilivie's Syndrome Mar 2007, Pulmonary Embolism Sept 2007, Collapsed lung Oct 2007, Recto/Vaginal fistula Nov 2007
 
drugs: Asacol, Imuran, Remicade, Humira, Prednisone, Canasa, Fentanyl, Warfarin, TPN


FallColors
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Date Joined May 2007
Total Posts : 1220
   Posted 7/14/2008 4:20 PM (GMT -7)   
Hello,

Did he have an abscess drained? Is he on any antibiotics?

chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 7/14/2008 8:56 PM (GMT -7)   
Mine seton will turn 2 in Sept. :) When you looked at it, you should have been able to see the seton. Mine is red, and hangs out of the fistula hole a little, and is tied in a knot there. His pain seems abnormal to me. I would call....and ask them about the pain, and also ask if you should be able to see the seton.

DianaN
New Member


Date Joined Jul 2008
Total Posts : 3
   Posted 7/15/2008 2:41 AM (GMT -7)   
Thanks for all those valuable info..Yes,he had pereanal fistula.2 months back he had a abscess drain for it.Then they went ahead and did a seton insertion this time.He says he can feel that something is there(may be thats the seton?) inside the hole,though i can just see a hole from outside.

sr5599
Veteran Member


Date Joined Aug 2007
Total Posts : 1202
   Posted 7/15/2008 10:15 AM (GMT -7)   
I had to have two setons - the second was to replace the first. Both times I could see the seton on the outside. I had the "string" type. I think the rubber types (tubes? someone who's had them could say) also are visible.

Regarding the pain, I had quite a bit at first. The cut to drain the abscess hurt like heck. The first seton was never comfortable. But, when they replaced it I was comfortable.
--40 year old female, dx as UC in '04 (1st symptoms in '03), switched to Crohn's in '05, 1 fistula, crohn's colitis, limited to large intestine
--rejected (reaction/didn't work): Asacol, AZA, 6-MP, MTX, Remicade, Humira, prednisone
--methylpred - finally off 6/15/08, tried Prochymal in Phase III study (can't wait til it's approved!)
--started Tysabri 3/21/08, started Xifanan 5/24/08 
--single mom to 10-yr-old girl


HabsHockeyFan
Veteran Member


Date Joined Jan 2006
Total Posts : 3130
   Posted 7/15/2008 10:54 AM (GMT -7)   

all good comments already.  I would just say that the pain depends on how much muscle area is involved.  I was very lucky with my seton...it was not into too much muscle so I had little pain.

I never saw the seton (can't bend that well and did not have nerve to ask my then fiance to look :-) ).  I could feel the little knot when I wiped though.

It sounds like he is in more pain than others expressed.  callyour doc for your own peace of mind.


Dx'd '90 (emergency rupture), symptoms ignored long before that, '03 fistulas and bad flagyl reactions, B12 weekly, Pentasa [until I surrender to the bigger meds]
I'm riding on the escalator of life....


DianaN
New Member


Date Joined Jul 2008
Total Posts : 3
   Posted 7/15/2008 1:18 PM (GMT -7)   
Ok..makes sense!For him ,fistula had passed through sphincter muscle,so they had to operate muscle partially.Anyway i am going to be in touch with doc.
Thanks again!

Wee Me
New Member


Date Joined Sep 2008
Total Posts : 5
   Posted 9/18/2008 3:28 PM (GMT -7)   
Hi there, I had a seton drain inserted for a perianal fistula 7 days ago (comes out my anus and loops into a small entry point near the underside of my vagina). Until last night, my pain was minimal.

However today, I have the same dull ache in my anus that I had when the symptoms for the fistula started about 10 days ago. This becomes a sharper pain depending on how I'm sitting. Am I getting another one or is this to do with the seton? I'm getting really scared. My boyfriend is away on business for 3 months so I'm dealing with this alone. Also, we live in the New Zealand and I have no idea how to contact my surgeon directly!

patientspiders
Veteran Member


Date Joined Jul 2005
Total Posts : 733
   Posted 9/18/2008 6:35 PM (GMT -7)   
All of the answering posts on here are awesome. The only 2 cents that I have to contribute are these:

With both the tube-type seton, and what I called the "rubber band of doom" like the one Wee Me described... I had to be careful of how I sat for long periods of time, and also how I slept. It might not hurt at the moment, but if you sit the wrong way for too long it can cause intense pain later on. Same with sleeping... while I had mine in I did my BEST to sleep on my belly... I found that the less pressure applied to the area the better it felt.

If the pain becomes too intense, call the doc for sure. I had a few issues with my setons "blocking" the drainage of the very fistula and abscess it was supposed to be helping - especially the rubberband one. I found that moving it around would release the pressure and the icky stuff. I know that doesn't apply to the original situation, but it might help Wee Me...

And take your sits-baths or warm tub baths. A few days of slacking on those and I would DEFINITELY feel the difference.
Good luck to you guys... I know how rough having those stupid things is!
26f, dx'd CD July '05 after 6 fistula/abscess surgeries
Currently running on Humira and Hope.
(miscarried at 13 weeks, now waiting to heal before trying again)

"Our greatest fear is not that we are inadequate, but that we are powerful beyond measure."

~Marianne Williamson


chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 9/18/2008 7:43 PM (GMT -7)   
Wee Me....there should have been a number on the discharge papers for you to reach the surgeon...at least that is the way it is in the States.

Is your fistula still draining? I had mine get kind of blocked up for a couple of days, and the pain and fullness came back, but then it started draining again, and I haven't had an issue since.

Wee Me
New Member


Date Joined Sep 2008
Total Posts : 5
   Posted 9/18/2008 9:42 PM (GMT -7)   
Thank you so much for your responses. Can't tell you nice it is to speak to people who know what's what! I mentioned I live in NZ, but I'm actually from Ireland... hence the bewilderment around the health system here! Also, the hospital has no record of discharge notes and can't track down the surgeon who carried out the procedure. Hmmm.. I actually have private health insurance but they won't let me use it now because I was sent in through the public system! Grrr.

Anyway, back to the point. I rang my GP and spoke to her nurse who told me to go to the emergency room again. So 3 hours later, I was examined by an ER doc and a random surgeon. They said everything seems clean and couldn't explain the pain. BUT they pumped me with some IV antibiotics and, I have been prescribed 2 weeks of antibiotics (they had only given me 3 day's worth after my op).

This should bring me up to the follow-up appointment with the elusive surgeon (for which I still haven't received a letter but the random surgeon today promised he would chase it up).

So - antibiotics for now. Pain feeling better and I have lots more paracetemol here. Will let you know how I go. Nothing seems to be draining very much really. A bit of yellow/ green from bum and exit point which the doc told me is ok.

Thanks again. I realise that this is a Chron's forum, which I don't have, as far as I know... This is such a strange problem that no-one really understands so it's great to have this here.

Ides
Forum Moderator


Date Joined Nov 2003
Total Posts : 7077
   Posted 9/18/2008 10:09 PM (GMT -7)   
Wee Me,
At the time they they placed the steton for the fistula, did the doctor ever mention what the cause of the fistula might be? Fistulae are not something that normally occur without some disease process or trauma to the area. Women that have given birth recently can sometimes develop fistulae. And there is one disease that unfortunately has the majority of fistulae issues.

When you are in a postiion to do so, I would begin to delve into the reason you have a fistula. The sooner a reason can be identified, the sooner you can begin to treat the underlying problem.

Please feel free to ask any questions you might hava here regarding your fistula issues. We have lots of fistula experts here that are more than willing to offer suggestion and opinions.
Moderator Crohn's Disease Forum
CD, Ankylosing Spondylitis, lupus, small fiber peripheral neuropathy, avascular necrosis, peripheral artery disease, degenerative disc disease, and a host of other medical problems.
 


Wee Me
New Member


Date Joined Sep 2008
Total Posts : 5
   Posted 9/18/2008 10:44 PM (GMT -7)   
That's a good point Ides. Hmm.. no well, not really. Apparently, they probed me a bit when I was under and apparently, there was no signs of Chron's. I haven't given birth either. Nurse in the hospital said some people are just unlucky.

I'm generally healthy. No major gastro issues. I have a good diet, and I do (did) lots of yoga although I do strain occasionally when I go to the loo, which I fear may have caused the fissure that lead to this fistula. I also had a fistula in ano about 6 years ago which was fairly superficial and just nipped out in day surgery. Never had another problem until now. Anything that I can do to avoid another fistula will be done! I'll even give up alcohol... and that's a lot for an Irish person to say!!

patientspiders
Veteran Member


Date Joined Jul 2005
Total Posts : 733
   Posted 9/18/2008 11:42 PM (GMT -7)   
Wee Me, I don't mean to alarm you, but your story begins exactly like mine did and I don't want you to go through that!

I went through FIVE fistula-then-abscess surgeries. Each time they looked in my colon and saw NO sign of crohn's. FIVE times. FINALLY, a new GI ordered a Colonoscopy and they discovered the crohn's via biopsy. The crohn's was manifesting itself via fistulas where there was NO sign of crohn's. My crohn's was in my illium, not my rectum, but it was still the cause.

PLEASE, have a colonoscopy done as soon as you can. Just to rule it out.
26f, dx'd CD July '05 after 6 fistula/abscess surgeries
Currently running on Humira and Hope.
(miscarried at 13 weeks, now waiting to heal before trying again)

"Our greatest fear is not that we are inadequate, but that we are powerful beyond measure."

~Marianne Williamson


Wee Me
New Member


Date Joined Sep 2008
Total Posts : 5
   Posted 9/19/2008 3:27 PM (GMT -7)   
Thanks for the advice. I have to admit, I was alarmed, but have had a bit of time to get my head straight. When I can finally get to private rooms to see a consultant, I will request a colonoscopy, for peace of mind, if nothing else. It's all a bit scary, but you're right... better to know.

We are supposed to be moving to Australia in a few months, where I can only get public healthcare until private insurance waiting periods are over so I will try to get all of this done in NZ (if they EVER find my case notes!!!).

chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 9/19/2008 5:58 PM (GMT -7)   
A guy my husband used to work with had a fistula quite a few years ago. He doesn't have crohns, and had no other issues. They couldn't explain why it happened, but hopefully, yours is just the same as his, and you will get a clean scope.

Wee Me
New Member


Date Joined Sep 2008
Total Posts : 5
   Posted 9/27/2008 5:43 AM (GMT -7)   
Little update from me.

Went to my outpatient's appointment in the hospital on Thursday. They've finally found my case notes (yay!) and the GI specialist has agreed to treat me privately. At my request, I'm in for a colonoscopy on Friday. Then the specialist wants to fit an anal fistula plug at the start of November. Although I know claims of 85% success rates by the medical companies are seriously far-fetched, I'm hoping the plug will work for me!

PS. I'm finally getting used to the seton. Doc told me I can go back to yoga next week - can't wait.

PPS. I'm such a techno-disaster... I've inadvertently managed to delete the nice response from chroniemomx2 from my view.. Oops.

Post Edited (Wee Me) : 9/27/2008 6:55:33 AM (GMT-6)


aravind
New Member


Date Joined Dec 2008
Total Posts : 4
   Posted 12/23/2008 12:33 AM (GMT -7)   
Advise Please... I have Seton inseted last week (Dec 16, 08) after surgery for Perianal Fistula, this is abscess turned out as fistual (Doctor said it is complex HorseShue Fistual). I am having continuous pus drain and pain is increasing. Thank God, surgery is after three months of suferring from the pain.

Please advise me for following: 1) How long the seton stay in my body 2) Any possibility of recurrence? 3) Usually how long this kind of Abscess/Fistual takes to heal.

I have good medical insurance coverage and good surgen (I belive, so), do I need to be concerned of any thing or additional tests?

Thanks,
Aravind

Ladybugs
Regular Member


Date Joined Jan 2006
Total Posts : 158
   Posted 12/23/2008 6:37 AM (GMT -7)   
Aravind:
 
I had the same kind of fistula you did - a horseshoe perianal fistula.  I've had my seton for about a year and a half.  My doctor seems to think there's a good chance that the fistula will never heal and I'll always need the seton.  He said eventually this seton will break and I'll need to have another put in.  Often some of the biologic drugs like Remi or Humira can induce fistula closure, but those didn't work for me.  Like I said, I've had this seton for a year and a half and it still drains like crazy.  As much as I hate it, I'm resolved that I'll likely have it forever.   Good luck to you - I hope yours heals :)

aravind
New Member


Date Joined Dec 2008
Total Posts : 4
   Posted 12/26/2008 4:42 AM (GMT -7)   
Ladybugs:

Thank you very much for the information. I think we are all going throuh same painful life. I could not attend Christmas eve because of this. I am expecting to heal by Holy God intervention and touch.

I have a some update from myside. I had a follow-up with my surgen two days ago and she said, it is healing well and 1-2 weeks away from taking out the Seton. She also mentioned that, reduction of pus quantity drain w/ no fever and chillness is sign of improvement. Now the pus drainage is reuduced noticebly since yesterday. I live in Southern California, I have checked with few other surgens (I could get expert surgens advises through friends), they said usually it should heal in 1-2 months depending on how complicated and possible recurrence in future. In my situation they anticipate another 2-4 weeks, Hallalujah... If this is the situation, I hope I am getting out of it soon. In any case I need to observe for next few years.

Also another update in last couple of days is: I was advised of Homeopathy or Ayurvedic medicine to stop recurrence. I just came to know, for fistulectomy or abscess surgery, this is best options it seems and popular in India, also prevents reoccurance as the medicine works well and develops the antibodies/resistance (do not know exact medical term). I did not believe this and I am checking with some other refeences through friends, if it turns out to be positive to stop any possibility of recurrence, I am planning to get from India and use. As I heard, Homeopathy or Ayurvedic medicines does not have any side effects and can continue along with allopathic. I will update if I have any positive updates on Homeopathy or Ayurvedic medicine.

Thank you all.

aravind
New Member


Date Joined Dec 2008
Total Posts : 4
   Posted 12/29/2008 3:48 PM (GMT -7)   
Update today:

Pus reduced drastically since last 4 days and almost minimal today and apparently I had Doctor visit today... Doctor determined that it is healing very well and took off the Seton, Cathetor and left the wound open to continue to heal on it's own. Also Doctor said it takes good 6 weeks to heal completely. He is not expecting any surprises, but will keep follow-ups for every 10 days for few months.

After 3-4 months of pain and unable to sit in past 2 months, it was just like hell, if this is like hell, how real Hell will be. I should thank God for showing this situation and helped me to correct myslef and avoid the real Hell.

I should be able to sit in next few days... Hallelujah... and time to praise and worship God in loud.

Update on Homeopathy medicine: Spoke to couple of people who used homeopathy for fistula and hemmoriods treatment. As per the info I've received, this will stop the recurrance and improve the resistance power, but it is long process (improvements start after a month and treatment will be more than 6 months). As per info I got so far. 1) It will work on exising fistula tracks/pus to heal first 2) develops resistance 3) Subsequently stops recurrance.

I will need to chceck with few more people and also Homeopathy Doctors and update again.

ArtistMum
New Member


Date Joined Jan 2009
Total Posts : 12
   Posted 1/26/2009 3:25 PM (GMT -7)   
I had a drainage tube or seton? Put in after an emergency hospital stay on Jan 13th. I am a 47 year old woman and spent 8 days in hospital. I left with draining tube or is it called a Seton. Like the lady from NZ I was told practically nothing. All I know is that is will be a long year ahead of me? Whatever that means? Also I am to have a colonoscopy to rule out Chrons next week. I was told the fisula and source of abscess are complicated....and nothing else.
 
 
Its daunting really, I mean one minute you are blowing out the candles on your birthday cake and the next minute you are in an ambulance with a fever so high your rambling away. Then surgery, then tubes for draining and then your out of hospital and you have no idea what the hell is going on?
 
The only thing I have been told is its going to take a year?????? What about the fistuala operation? When do I have that? What are they on about? Why did I get this? Am I not too old to be dx with Chrons disease? Wouldn't I have known it before. I have nurse who comes to the house daily to check my stats and wound, I have two holes in me with the tubing hanging out....I am not sure if this goes to the fistula or abscess? I don't know much at all I'm afraid. I was that sick in hosptial.
 
So, I am glad to be with others who can explain things to me better. I feel like I did this to myself because I was not clean, but I know I'm clean, I just don't understand how this happened to me. I suffer bipolar disorder and so I am very down at the moment. Any emails would help me. B
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