Seton insertion- Just looking for feedback.

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not creative
Regular Member

Date Joined Mar 2007
Total Posts : 466
   Posted 11/19/2009 8:07 PM (GMT -6)   
This whole thing started back in Feb 09 when I went into the ER with three major abscesses that were I&D'd. Since then I've been having issues with more abscesses and then fistulas opening up.

So two days ago, I went under general so they could do an exam with poss fistulotomy and seton placement if they could find somewhere to put one. Boy did they find a place! They inserted three setons into three separate fistulae. I apparently have 7 or 8 holes, but three were actually fistulas with tracts to my intestines.

I'm a little curious about how these are going to heal anything- I know they are going to prevent further abscess and that's great, but healing? I don't think they're the cutting kind because they are just looped and tied and she said nothing was stitched to me. They are red and they look like the twist ties that keep bread fresh. They don't really hurt, they are just uncomfortable and weird feeling- I guess I have to get used to tubes hanging out of my anus! Are these supposed to heal anything, or just hold the holes open?

Does anyone have any feedback? Advice? I'm afraid I'm not going to keep them clean enough.

Also, they found a stricture which I didn't know was there. She said she used her fingers to dilate it (which means it's not far in) but now Im worried about it closing back up again and then I'll be in real trouble. The doctor told my husband that my next step might be colostomy. I knew that was probably my future but it was something to hear the surgeon say it. Then again if I had an ostomy and never had to use my anus again- it would be a welcome reprieve.

I'm glad I'm finally feeling a bit better as far as the abscesses and fistulas are concerned, but it's never ending, there's always something else wrong...and all they ever say is "it's a tricky disease" well, I know that, I live that!
Laurenne, 25 Graduate from University of California, Davis. BA-Anthropology
Dx'd w/ IBS and CD in 2002. Three abscesses that are now fistulas.
On: 6MP, 20mg Prednisone, Zoloft, Cimzia (working so well, I'm on Miralax too!)
Tried: LDN- Did nothing good, Remicade- allergic, Humira- no reaction

Regular Member

Date Joined Sep 2006
Total Posts : 171
   Posted 11/20/2009 2:26 AM (GMT -6)   
Hi Laurene,

I don't know anything about setons but hopefully someone else will respond regarding those. I'm really sorry you're going through so much right now. I hope your husband is as supportive as my wife is, I don't know what I'd do without her.

I don't know a lot about this disease (dx April 2006) but it seems a lot of people have good times and bad times, I hope you have a good time coming real soon, it sounds like it's your turn.

Hang in there!
I feel a whole lot more the way I do now than I did a little while ago.

Veteran Member

Date Joined May 2007
Total Posts : 1220
   Posted 11/20/2009 9:50 AM (GMT -6)   
Hello Not Creative!

I am glad you have the setons inserted! You are right that the hold the fistula track open so the "stuff" can drain out. Otherwise the fistula would clog and trap the stuff -- abscess!!! I hate abscesses!! My whole health really turned for the better once I got the setons. I felt really bad all the time before I got them, and I now know that was from constant infection around the fistulae.

This may be a long, multi-step process for you. But keep in mind that you are moving in the right direction!! First step was to clean out the abscesses. Step 2 - get setons so the infection won't get trapped. You will slowly heal and tissue inflammation will slowly go down. I also am allergic to remi and humira, and am one 6MP now. It seems to help. I've been abscess free for 19 months! It can promote healing of fistulae and turn down the body's inflammatory process, which is the root of this evil. This can take many, many months, but hang in there! It gets better! The fistulae won't close with the seton, but no abscessing and no inflammation is quite livable. If the healing goes well, you may be able to get surgery (step 3) to deal with the fistulae. Sometimes they can close on their own, but unfortunately in CD you more than likely will need surgery.

To keep my setons clean, I use a hand-held shower sprayer after I poo. I go in the toilet and then sit on the side of the tub (one foot in the tub, and one foot outside) and spray it all away. This works really well! I am in love with my shower sprayer! After I dry off, I use 4x4 inch soft guaze squares and fold it around the setons to cushion them and catch drainage. I don't even feel it anymore.

You need to watch that the drainage doesn't iritate your skin and you get a skin yeast infection (Diapher rash). It causes your skin to break down and is amazingly painful! Use a baby diaper rash cream to shield your skin from the drainage and prevent rash and irritation. I like Balmex because it smells better than others.

When I go out, I always carry flushable, alcohol free wipes and a spray bottle that can adjust to a stream (not a mist). I use the spray bottle to help blast stuff out. Between the spray and the wipes, I can get things clean enough. If I travel somewhere over night and there is no hand-held shower sprayer, I get in the tub and use a very wet wash cloth. Over time you will find what works for you. Right now -- so soon after surgery -- it is important for you to keep it clean!

My setons are a very fashonable red too! My doctor joked that they are a weird body piercing (!). I doubt anyone would choose this type of piercing!!

I am glad you are feeling better! Be very patient and you will just get better and better!

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.

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