abscess/fistula, MRI follow up... advice needed

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jesflr337
Regular Member


Date Joined Aug 2009
Total Posts : 41
   Posted 9/8/2009 8:39 AM (GMT -7)   
Hey everyone,
My MRI from last week "showed nothing conclusive." There may or may not be a 1 cm lymph node, but this is not in the area I am feeling pain.
I have two bumps, one pea sized on the left of my anus (very hard and painful when pressed on) and the longer one (2 cm by 3 cm) that runs on the right side of my rectum, up towards my tailbone. The back side of my rectum between these two bumps is very tender. Even though I can FEEL both of these, as can my surgeon, they do not show up on the imaging. Not a surprise to me really, my abscess didn't either. He put me back on the antibiotics- for how long we don't know.
What should I do now? I can't give up, the pain and pressure returned one day after being off the antibiotics... and he's saying he is not sure, but thinks this is "just" scar tissue. This has already gone on 3 1/2 years, I'm not sure how much more of this I can take... Scar tissue doesn't create pus does it? I'm so confused. He also said that while he is not taking it totally off the table, he does not think this looks like Crohns of the rectum... it doesn't look like anything he's seen before. Yay me.
 
I've made an appointment with another CRS for another opinion. And one with my primary care doc just in case she has any new insight. I just feel like I almost certainly still have an abscess or fistula, it FEELS just like the other one. Do I trust my gut :) or keep "waiting and seeing" like my doc wants me to? Should I make an appointment with the GI specialist who I haven't seen in 3 years?
Are there any other imaging studies they can do? I wonder about vaginal ultrasound, however looking back towards the rectum... or how to confirm that the hard painful tissue is in fact scar tissue and not another abscess? I asked about needle aspiration but he did not think that was appropriate. It feels like a hard little balloon on my right side of my butt...
 
Sorry for the rambling, just not sure where to go from here.
 
 

FallColors
Veteran Member


Date Joined May 2007
Total Posts : 1220
   Posted 9/8/2009 9:19 AM (GMT -7)   
I had persistant cellulitis for several months. We figured this out only after my doctors put me on flagyl & levaquin for 2 weeks, but then it got very ouchy again. So back on the antibiotics for a week, and then ouchy -- this cycle happened several times. I would see my surgeon and he would only see some edema and a little redness -- but it really hurt! Then my GI said just stay on the antibiotics. That worked! I certainly didn't like being on them for so many months but it worked. My GI said the inflammatory response from the CD combined with tissue that has been messed up by abscesses can result in persistent cellulits. I suggest you ask them for several months of antibioitcs -- what do you have to loose?? Also, the combination that worked for me was flagyl and levaquin (cipro's stronger cousin that is excellent for cellulitis).
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.


jesflr337
Regular Member


Date Joined Aug 2009
Total Posts : 41
   Posted 9/8/2009 9:29 AM (GMT -7)   
Thanks FallColors!! Were you able to go off of the antibiotics eventually?
How do you diagnose cellulitis- or is it just that is what you call the chronically inflamed tissue?

FallColors
Veteran Member


Date Joined May 2007
Total Posts : 1220
   Posted 9/8/2009 2:11 PM (GMT -7)   
I was on the combination of levaquin and flagyl for 8 months total. Actually, I stopped the flagyl after 6 months because I got peripheral neuropathy (a side effect -- tingly toes -- all healed now). Levaquin was 500 mg/day and flagyl was 1500 mg/day (500 3x per day).

Cellulitis is a somewhat general description of infected tissue. Usually doctors are familiar with infections of the skin's surface -- like when kids fall and cut themselves. My doctor realized I had a persistent deep tissue infection that wasn't being killed by normal courses of antibiotocs -- the infection kept returning. So he said stay on it for several months and then we will stop and see. I suggest you google cellulitis. So it was just logical to decide to stay on them longer. And these are the best antibiotics to be on for cellutils and infections with rectal involvement (not much else is stronger). I hope this is making sense!

f your doctors can't figure out what is causing your problem, why not try a long course of antibiotics. What do you have to loose? If your doctor is skeptical, please see an infectious disease specialist. Those doctors are used to solving difficult puzzles and they think more "outside the box". Most teaching hospitals have infectious disease doctors.

I hope you find the answer soon!
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.

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