abscesses am i getting right treatment

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penelope-marie
Regular Member


Date Joined Sep 2008
Total Posts : 54
   Posted 3/20/2009 3:07 PM (GMT -7)   
I had an abcess on my bowel which they tried with antibiotics but it got worse and they drained it with a needle 2 sites.They refused to do a surgical drainage as they would only do that cobined with a rsection which i dont want.Luckily the drains + antibiotics worked and iflammation was way down so went home.

that ws 4 months ago now i am back in hospital, got big absess which was surgically drained ie they cut me open and vacuumed up the contents.They say wound wil heal but will become a fistula with pus leaking or worse.

They seem to be saying only way to stop abscesses is cutting out portion bowel. But on this forum there are people who have had other treatments not using surgery so i really ned to hear your ideas. Has anyone had more than one abscess then got better?

Are there ways of resting your bowel to give it a chance to heal like liquid diets?

I am lying in hospital very confused and worried and dont know where to turn and drs all saying different things doesnt help!

Any thoughts???
had crohns for 15 years took pentasa then nothing but diet but stricture appeared 3years ago and problems since.


patientspiders
Veteran Member


Date Joined Jul 2005
Total Posts : 733
   Posted 3/20/2009 4:09 PM (GMT -7)   
First off, I'm so sorry you're going through this. I know how frustrating it is with abscesses, heavens!

My number one recommendation is Remicade. I had INCREDIBLE complications with an abscess, which they drained and/or operated on MANY times over the course of a year+ (no resectioning, just draining). Nothing worked to keep the abscess drained, including drains really. The only real lasting improvement I saw was about a month into Remicade - the abscess was healing so quickly that the drain actually hurt because of it. After about a year of Remicade, I was abscess and drain free, and I have remained so ever since. My last abscess surgery was in 2006. I haven't had any Remicade for over 12 months now, and I still haven't had any trouble with abscesses even though I've been in a flare. I hate to be a "promo person" for the big biologic meds, but Remicade saved me from losing my colon, so no complaints here. (my abscess troubles were on my bumm)

Doctor's like to say that "the only way" is to slice ya, and sometimes that may be true. However, after years of crohn's and hanging out around here - I would have to be of the opinion that "the only way" to avoid surgery in your case is to get into remission, ASAP. Easier said than done, I know. My point is - you have to get the entirety of your crohn's under control, and then the abscess has a chance to heal and go away. If you're in a constant state of inflammation and turmoil in your intestines - it doesn't matter how many times it's drained, or how many slices or dices are made I don't think. It'll just come back.

As far as resting your bowels - if you're in the hospital and it is available - I highly recommend TPN. I don't remember what it stands for, but it's basically food in a bag that goes into your vein... it's like the bare-bones essentials of lipids, etc, that your body can soak up without making your guts do a thing. It's pricey, but my insurance paid their normal "chunk" towards it.

I really hope you get some answers soon, and good luck with everything!
27f, dx'd CD July '05 after 6 fistula/abscess surgeries
Remicade '05 through '08, with no other maintenance meds
Noticing a real difference with a Gluten-Free diet.
Currently on:
Cimzia (loading doses 2-12-09)
Probiotics, Digestive Enzymes, and Prednisone


Kenny23
Regular Member


Date Joined Aug 2005
Total Posts : 128
   Posted 3/20/2009 4:13 PM (GMT -7)   
I do think resections are common in this situation. I had a bowel abcess that got better with antibiotics, but it was back in 6 months and I had a resection.

An abcess will form at badly diseased portions of bowel. If you can't control the inflammation with medicine, then it will probably keep coming back. I wish there were more choices, but we are limited. If you keep getting recurrent problems a resection may be the only option.

73monte
Veteran Member


Date Joined Mar 2007
Total Posts : 1497
   Posted 3/20/2009 5:48 PM (GMT -7)   

Hi Penelope,

May I ask where your abscess is located? Also, was there a fistula present? My daughter had an abdominal abscess 3 months ago. It was at her Termianl Ilium, and had a fistula to it as well. It was treated with a CT guided drained, and a drain line in for about a week. She took Flagyl for several weeks afterward, and seems okay so far. Our GI did suggest Remicade as well, but I'm really not ready to try such a sophisticated drug yet, and have opted for Imuran. 


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Has used Prednisone and Pentasa. Started Imuran (02/09), had an abdominal abscess (12/08). 2cm of Stricture.


penelope-marie
Regular Member


Date Joined Sep 2008
Total Posts : 54
   Posted 3/21/2009 1:45 AM (GMT -7)   
Thanks for replies.

Patientspiders- sorry to hear yr abscess experiences . The odd thing is mycrohns seems ok, no probs with BMs.As for TPN, sounds just what I need but drs are so fixated on surgery they wont do it.

73monte - my abscesses have been on terminus of ileum like yr daughters one. buT one was at front and one at back.

Good to know theres others out there!
had crohns for 15 years took pentasa then nothing but diet but stricture appeared 3years ago and problems since.


dreamer06
Regular Member


Date Joined Jun 2008
Total Posts : 221
   Posted 3/21/2009 6:12 AM (GMT -7)   

I have had abcesses and fistulas since I was diagnosed a year and a half ago.  I have been on remicade for about as long and have had six surgeries to try and drain them.  Mine just wont go away.  I know that they can do a bowel resection but other than the abcesses I am not that bad as yet.  My doctors tell me that everyone is different. 

I know how challenging this is, but give it time and see if it will heal on its own.  Dont go for a resection unless you really have too. 


73monte
Veteran Member


Date Joined Mar 2007
Total Posts : 1497
   Posted 3/22/2009 7:21 PM (GMT -7)   
I must admit, you guys are scaring me abit. I have been worried, (I'm a worrier), for the past few months about reccurrence. When you hear stories like these, it doesn't inspire alot of confidence. Don't get me wrong, I certainly appreciate that you're all looking for imput and answers just as I am. I hope you get the right treatment to get these complications under control. 
My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Has used Prednisone and Pentasa. Started Imuran (02/09), had an abdominal abscess (12/08). 2cm of Stricture.


westat
Regular Member


Date Joined Jun 2008
Total Posts : 167
   Posted 3/23/2009 7:41 AM (GMT -7)   
Honestly I wouldn't go for the rescection theory. I had 2 abcesses after my resection a few mobths ago. My resection was for a stricture but I had 2 abcesses one after the other after he surgery. Mine were drained by inserting a CT guided drain. And taking Flagyll and Cipro for 3 weeks. They took as much fluid out as they could at the time. I then had to flush it 3 times a day with sailine through the drain. It has been about 1 1/2 months since my last abcess and I am doing fine.

I would ask about a drain if I were you. They typically only take a week or so to heal depending on the type of drain. I like the idea of the ones that can be flushed because it helps push all the yucky stuff out.

Tanya
Dx with Crohn's in 1997 after 5 years of worsening symptoms.
Resection a few months after dx after 1 month on TPN and IV steroids.
Resection October 2008.
Also have severe asthma.

Tried: Pentasa, Cholestyramine

Presently taking: now on 10 mg prednisone, Imuran, probiotics, calcium, B12.
For asthma I take Advair 500, singulair


73monte
Veteran Member


Date Joined Mar 2007
Total Posts : 1497
   Posted 3/23/2009 8:47 AM (GMT -7)   

Hi Tanya,

My daughter had the exact treatment as you describe for her abscess. It's been a few months so far. She was on Flagyl for somewhat longer though. Thanks for the reply, It's always good to hear about treatment success.

Tom.


My daughter was diagnosed Feb. 19/07, (13 yrs. old at time of diagnosis), with Crohn's of the Terminal Illium. Has used Prednisone and Pentasa. Started Imuran (02/09), had an abdominal abscess (12/08). 2cm of Stricture.

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