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bad bum bob
New Member


Date Joined Jan 2009
Total Posts : 4
   Posted 1/14/2009 6:12 AM (GMT -7)   
i had an opperation in march 2008 to drain a perianal abcess, which seemed to go ok, i had the abcess packed daily, but unfortunatly it never properly healed, and continued to leak a dicharge for several months. i have recently been back to hospital for a seton placed in my fitual,i have 2 pieces of plastic string coming from the place i had discharge coming from. the hospital have not really explained what a seton is,what it does, how long i will have it.ect. they just said to come back in 3 months.. i find it very painful.especially when i have BM, i have a young family and am self employed, and want to know when i will be ok to go back to work, and what i will be able to safely do, if there is anybody that could give me some advice. i would be very greatful....thanks bob  confused

Ladybugs
Regular Member


Date Joined Jan 2006
Total Posts : 158
   Posted 1/14/2009 6:29 AM (GMT -7)   

I'm sorry you're not feeling well and that your doctor didn't do a very good job of explaining.  I have a seton in my fistula too.  It's to keep the fistula open so it can drain.  This will keep it from getting infected and abscessing again.  I know it hurts.  I was in quite a bit of pain for the first few weeks after my seton was placed.  I've had it for about a year and a half now.  Some days it still hurts, but for the most part it isn't too bad.  Some people have luck with seton closure - lots of the drugs like Humira promote fistula closure.  Others of us don't achieve fistula closure.  I'm resigned that I'll have mine for the long term but I know there are people on this board who have achieved fistula closure and were able to get rid of the seton. 

One thing that I find to be quite helpful - I keep gauze on it all the time.  Otherwise, the drainage irritates my skin and makes the area around the seton sore.

Best of luck to you - hope you're feeling better soon.



FallColors
Veteran Member


Date Joined May 2007
Total Posts : 1220
   Posted 1/14/2009 6:45 AM (GMT -7)   
Hello Bob!

Oh I feel for you!!! I had a similar situation with an abscess that wasn't treated properly (by a general surgeon who didn't know crohn's). He just drained it. So it didn't heal. I got sooo sick when it abscessed again (it never realy went away). I can only encourage you that it will get better now that you have a seton!! At first I hated the thing but now I realize what it did for me. It allowed the fistula to stay open and drain. Without it, the fistula can become plugged and infection can't drain. Abscess!! With the seton, the infection drains right out. Now the antibiotics and your immune system can work to heal the abscessed area properly. Unfortunately, this can take weeks (in my case months), depending on how bad it was to begin with. Because my abscess wasn't opened and cleaned out properly and a seton placed, the whole area got really infected (cellulitis) and swollen with edema (fluid). It was painful to sit for months. Now I still have two setons and am back to normal activity. Praise God!!

Also, right after the seton was placed, it was a little painful, but that is because the doctor had properly cleaned it out and removed peri-anal skin tags around the anus (another delightful problem in some crohnies). The removal of the skin tags made BMs a ouchie for a while. But a quarter tablet of percoset solved that. The whole area got progressively got better over a week or two. I found a good way to clean the seton after a bowel movement is to use a hand-held sprayer in your tub. I straddle the tub (sitting on the side) and gently spray the whole area clean. Works great and minimizes tugging on the seton with toilet paper. Then I place clean guaze on either side to catch the drainage and cushion the seton. This helps reduce irritation and keeps the skin dry. Also, applying a zinc oxide cream (like Balmex) will help prevent diaper rash (a skin yeast infection that can form from too much icky moisture). At work, I use flushable wet wipes (no alcohol) and carry a small spray bottle.

I'm praying your whole area heals up soon! I found I could start working from home within a couple of weeks (even though I had to recline, I could use the computer). Have you seen your doctor again for a post-op follow up?? I wouldn't wait for 3 months to see your Doc if you see it going in the wrong direction (fever, increased swelling, feeling more un-well, etc.). I decided to be on the safe-side and see the doctor because this was all new to me.

Let us know how it goes for you!
Diagnosed early 2007 with rectal Crohn's.  Several peri-rectal abscesses and two fistulas with setons.  Allergic to Remicade and Humira.  Currently on 6MP.


patientspiders
Veteran Member


Date Joined Jul 2005
Total Posts : 733
   Posted 1/14/2009 10:18 AM (GMT -7)   
Good advice so far...

I had a seton that sounds similar to yours, but mine only had one string sticking out. As the fistula closed from the inside out, the string would show more and more. The doc snipped it a couple of times to keep it from getting in the way. Eventually, my fistula healed enough from the inside that it practically pushed the string out (it started to pinch really bad!), then the doc just tugged it out.

It was horrible for the first few weeks for me. I had a routine very similar too Fall's... I would just remove my clothing from the waste down, and stick my butt under the bathtub faucet and rinse until clean. I couldn't handle the pain of wiping. I also took several hot baths every day, and tried very hard to sleep on my stomach so that I would be relieving the pressure on my butt.

I also bought 4" x 4" gauze pads in bulk from a medical supply store (way cheaper than walgreens), and used those like they said above - to cushion the sore spot and absorb drainage.

I hope your pain eases soon, Bob... it really does get better with time!
27f, dx'd CD July '05 after 6 fistula/abscess surgeries
(miscarried at 13 weeks, now waiting to heal before trying again)
Stopped Humira August 22nd, 2008.
Went Gluten-Free, noticing some definite improvement.
Started LDN October 27th, and already LOVING IT.

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


Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3110
   Posted 1/14/2009 10:44 AM (GMT -7)   
Bob--sorry to hear of your pain!! I've been there too and all the info you've gotten is GREAT. Definately buy the 4x4's from a medical supply store...you'll use a lot of them and they are so much cheaper that way (I just folded one/sometimes two in half and stuck it in place). I had 3 seton's for about 7 years and I have to say that if you can keep the "knot" area on the outside it should feel better. I could actually move them easily (once the swelling went down) and my doc made the suggestion to keep them on the outside.

One thing I will suggest is that IF you start a fever that goes over 100, call you doc (I always called my C/R surgeon directly for faster service:)). It is important to catch any new infections early and your doc can address a course of action.

It will get better as the swelling goes down...I could always go back to work after one week...but I did spend that week laying on my stomach...OUCH!

chroniemomx2
Veteran Member


Date Joined Apr 2005
Total Posts : 2346
   Posted 1/14/2009 2:15 PM (GMT -7)   
You've gotten great advice. I've had my seton for 2 1/2 years now. I was back to normal a week after surgery. It causes me no problems and I love my abscess free life. :)

Baseball Mom
New Member


Date Joined Jan 2009
Total Posts : 2
   Posted 1/14/2009 11:51 PM (GMT -7)   
Well I also came looking for advise. I had my abscess drained and Seton placed the 22 of December. My DR said it was no big deal and I would be up and fine before Christmas. HA! Lier, Lier, pants on fire!!

Just this week I started driving again without too much pain. I just found myself laying in bed going from hip to hip. Sitting straight up was impossible!!

Dr. on follow up visit last Thursday just said, "Sorry. But had to be done." I found sitting in hot water the most comfortable. My Dr. also mention drinking Metamucil and eating high bulk food would be really helpful when it came to BM's. Also sitting on heating pad WORKS WONDERS!! The drainage is a PITA (no pun intended .. LOL) I used those big hospital pads they gave me for a while. But they were so bulky and uncomfortable I switched to gauze pads as well.

But my question is I have never been Dx'd with Crohn's Disease. Are fistula's and Crohn's always related? My Dr. never mentioned it. But it seems all I read they go hand in hand. I also read most people have them for such long periods.

My Dr said this will just stay in 8 weeks and then he will remove it and surgically repair the holes. Now I wonder if he is removing it to soon. (????)

It is amazing how so many ppl and Dr's have such different answers, suggestions, advise.

I am glad though I stubbled into this forum. Wish I had seen this prior.

bad bum bob
New Member


Date Joined Jan 2009
Total Posts : 4
   Posted 1/15/2009 2:37 PM (GMT -7)   
Thank God
Im not alone,
A great big (uk) thank you to all you folks who replied to my plea for help. Im feeling alot better than i was. no more tears accept when i need the toilet, im abit down hearted to think this fiasco could last for a long time, but hey theres people worse off in the world. So i wll just have to grin and bear it for now, ive taken all your advice on board, and once again thank you very very much for your help
BOB....

patientspiders
Veteran Member


Date Joined Jul 2005
Total Posts : 733
   Posted 1/15/2009 3:38 PM (GMT -7)   
Baseball Mom,

I'm going to tell you my story, NOT with the intention of scaring the begeezes out of you, but so that you'll understand why my advice is so serious.

I went through 5, yes FIVE abscess/fistula surgeries WITHOUT a diagnosis of crohn's. My abscess and fistula problems were all in the immediate area of my rectum. When the setons were inserted, the general surgeon and colo-rectal surgeons found NO TRACE of crohn's or inflammation in my colon. Because they saw nothing in my colon, they did not even bother to order a scope to see if anything was wrong further up the pipeline. (I was also having 10 BM's a day, but this didn't seem to tip anyone off)

So yes, you can have abscess and fistula problems without having crohn's... they assumed that was the case with me for over a year. But, and it's a big BUT - just because there's no active disease at the source of the fistula/abscess does NOT mean that there is no other problem to be addressed.

If you are having ANY kind of health problems out of the ordinary besides this fistula/abscess problem, please seriously consider getting a colonoscopy and having biopsies of any inflamed tissue they may find.

I truly, truly hope that you don't have crohn's, but I would always seek out second opinions, both on your current abscess and on your potential future exams. I'll be thinking about ya!
27f, dx'd CD July '05 after 6 fistula/abscess surgeries
(miscarried at 13 weeks, now waiting to heal before trying again)
Stopped Humira August 22nd, 2008.
Went Gluten-Free, noticing some definite improvement.
Started LDN October 27th, and already LOVING IT.

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


FallColors
Veteran Member


Date Joined May 2007
Total Posts : 1220
   Posted 1/15/2009 4:27 PM (GMT -7)   
Hi Baseball Mom,

When I had my first abscess, I was amazed when the doctor said crohn's. I have no other symptoms except a vitamin D deficieny that has been fixed with over the counter supplements. No other symptoms at all, and still none. But the surgeon took a tissue sample around the fistula opening in the rectum and it came back with gramulomas -- rectal Crohn's. Still so strange. We are a rare bunch. Only a couple post on this forum.

My doctors all say that you don't need to Crohn's to get abscesses and fistulae. Hopefully this is all you will have and you will ge better soon!!

And Bob! We are all here for each other! Take care!
Diagnosed early 2007 with rectal Crohn's.  Several peri-rectal abscesses and two fistulas with setons.  Allergic to Remicade and Humira.  Currently on 6MP.

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