perianal abcess

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rovin1959
Regular Member


Date Joined May 2009
Total Posts : 159
   Posted 7/18/2009 11:51 AM (GMT -7)   
Hello all. Here is my question.... I recently,3 weeks plus,  had a small intestine resection, insisional hernia repair, and" another" abcess drained. Dr.Manthye?sp @ Duke, who will become my doc,after pre ex. condition date( suggested,before I allowed my current surgeon)to operate, that I have a drainage tube inserted,after the abcess was drained this time. Well, he did not. I know my body well,as we all do. The problem today is .....,well for the last few days is  feces draining again, from the area . Anyone with this, knows the tunneling effect. I truely hate to complain,however the pain and risk of infection into my anal area, is my concern. I NEVER go to the ER or a urgent care, but??? Any suggestions? Ebson salt and lidocaine 2% are my friends today!
Mary Lynn


patientspiders
Veteran Member


Date Joined Jul 2005
Total Posts : 733
   Posted 7/18/2009 1:47 PM (GMT -7)   
As you said, the pain and risk of infection of an abscess in that area (or any for that matter) are serious concerns. If I understand your post correctly, you were supposed to have a seton/drain inserted and the surgeon didn't give you one? I'm a little confused.

I had a perianal abscess issue for over a year. I tried several different setons and drains, but really didn't manage to get rid of it until I started Remicade. I was in bad shape all round though, with very high disease activity, so I know that abscesses CAN be beat without the heavy meds sometimes. Just not in my case. I hope you find some relief, but I would definitely be asking why on earth you didn't get the tube if you were supposed to!

My abscess didn't have a fistula of it's own, so I needed the seton to create a drainage path.

There are many different kinds, so if you end up with more seton-specific questions, don't hesitate to ask...

Guaze 4x4 squares between my cheeks saved my sanity, as did keeping the area clean (salts are wonderful indeed for a good soak!). I also tried to keep the pressure off of it at night by keeping myself from sleeping on my back... it seemed to ease the pressure and pain a bit if I could manage to stay off my butt.

It might not be an ER or Urgent Care issue, but I would be getting a seton if there's fecal issues coming in to play. So sorry you're going through this!

Sending good thoughts your way.
27f, dx'd CD July '05 after 6 fistula/abscess surgeries
Remicade '05 through '08, with no other maintenance meds (ah, those were the days, eh?)
Tried Humira. Failed. Tried Gluten Free. Leaning towards Failure there too.
Currently on:
Cimzia (started 2-12-09) Again, not helping much, if at all.
Probiotics, Digestive Enzymes, Forvia vitamins, and calcium chewies
Feeling a bit jaded lately, but trying to keep my chin up.


rovin1959
Regular Member


Date Joined May 2009
Total Posts : 159
   Posted 7/18/2009 2:05 PM (GMT -7)   
Thank you so much for replying. I was typing too fast. Thoughts running faster than my fingers. I have the gauze in place. Seton is the word I was looking for. This is the 3rd time draining it. Fecal leaking without a doubt. Sooo, I am not overreacting in thinking I should call the doc /surgeon on Monday? This has been with me since Sept.08. Could be worse. Again, thanks!

Mary Lynn


FallColors
Veteran Member


Date Joined May 2007
Total Posts : 1220
   Posted 7/19/2009 4:25 AM (GMT -7)   
Hi Mary Lynn,

Yes, I would certainly call a competant colo-rectal surgeon about it. I am wondering about the drain tube. My doc says abscesses need to be completely cut open, scraped out, and left open to heal from the inside out. Bacteria can travel up tubes and find a nice sheltered, happy home in the abscess area, so he doesn't use drainainge tubes unless the abscess is very deep (or in the abdomin). Were is your abscess? I hope your dcotor takes care of it once and for all!
Diagnosed with Crohn's in early 2007.  Several peri-rectal abscesses and two fistulae with setons.  Allergic to Remicade and Humira.  Currently on 6MP, and vitamins D and B-12.


rovin1959
Regular Member


Date Joined May 2009
Total Posts : 159
   Posted 7/19/2009 6:20 AM (GMT -7)   
Thanks again for replying FallColors. about 4/6 mm from my anus. Just a mess. I agree with you. If this were my horse, I would call it proud flesh, and do just exactally what you sugg. I can't manage this on my own. The first thing he (my surgeon) say's is.".I did not do anything wrong." I think "he doth protest too much." Sched. to see my gastro gal on the 28th. She is in the same practice,but looked at me sideways,she is cool, and indicated with her eyes that things are not going as she likes. Today is going to be a long day. I hope your world is going well. If you are able, go have some fun for me!!!

Mary Lynn


FallColors
Veteran Member


Date Joined May 2007
Total Posts : 1220
   Posted 7/19/2009 9:42 AM (GMT -7)   
Hi again,

I have had two abscess form in just about the same area as my very first one. But the blame falls very squarely on the shoulders of my first surgeon, an excessively incompetent general surgeon. He really messed me up. I learned the very hard way that it is so important to find an actual colo-rectal surgeon who knows CD. Even though peri-rectal abscesses are farily common in the general population, typical treatments don't work as well in us CD folks. So I am wondering about your current surgeon. Don't let anyone cut you that isn't skilled in CD!

I took a look at Dr. Mantyh at Duke. The clinical interests listed on his website sound wonderful!

http://www.dukehealth.org/physicians/810ABC8F7B8D9BC585256DFD006A93D1

I suggest you get in to see him ASAP. Call and beg if necessary.

I prefer colo-rectal surgeons attached to teaching hospitals. I think they tend to keep up on latest knowledge, colloborate with other doctors, and get paid a salary. Private practice surgeons get paid by the procedure -- so guess what they like to do! If you are on a salary, I think you would be free to focus on the best treatment even is it doesn't require cutting. Just my opinion.

Take care!
Diagnosed with Crohn's in early 2007.  Several peri-rectal abscesses and two fistulae with setons.  Allergic to Remicade and Humira.  Currently on 6MP, and vitamins D and B-12.


rovin1959
Regular Member


Date Joined May 2009
Total Posts : 159
   Posted 7/19/2009 4:21 PM (GMT -7)   
Thanks again for the reply. He was great!! I am out of pocket with him until Jan.10th.(pre ex. due to insurance) He could NOT believe that my flap,acscess,hernia,bloodwork was so poorly treated. He could not believe that canasa was the only cd med I was on. He did a scope within min. He is also about my age. It was nice to have the chief guy call me"one tough lady." I have no idea who to see except my guy in Greenville, NC. I am on the coast. He said he would be glad to become my doc. when I can. He mentioned he would hook me up with one of his gastro friends too. That sounds like a date, didn't mean it like that. Although...................... Hope you had some fun today.

Mary Lynn

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