Perirectal Abscess

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blankstare
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Date Joined Jan 2012
Total Posts : 12
   Posted 1/2/2012 2:11 PM (GMT -6)   
Let me say, December was awful. I developed a perirectal abscess and had emergency surgery with a spinal Dec 4th. The surgeon packed the wound and I was in the hospital 2 days. Packing came out out on the 6th and I was sent on my way. Felt better in about a week, for about a week. Started having pain again on Dec 22nd, but was determined to get through the holidays. Figured it was just residual pain, right? Wrong. Was back in for another surgery Dec 28th, this time having a drain put in. I have never been in so much pain. I'm in tears every day from the pain and don't know how much longer I can take it. On cipro, flagyl, and percocet, taking several sitz baths a day. Anyone know how long I can expect to feel this bad or have any advice? Surgeon said i'll have another surgery in 4-6 weeks to put in a fistula plug. I just want it all to end. :(

wednesday77
Regular Member


Date Joined Oct 2007
Total Posts : 349
   Posted 1/2/2012 10:40 PM (GMT -6)   
Oh no, that is terrible! I had a perirectal abscess and took cipro & flagyl for the antibiotics but the dr thankfully gave me stronger pain meds. It is an awful pain, I know. I would talk to your dr and tell him/her EXACTLY how much pain you are in - some drs are afraid to prescribe pain medicine but that is what it is meant for. I hope you feel better soon and get some relief; they are terrible but once they do heal then you won't feel this pain. Do you mind if I ask what your situation is, is there someone taking care of you?

xo
Crohn's Colitis
35 year old female
DX 2006
Currently on Humira, Xanax for anxiety, multivitamins, extra Vit D and calcium
In the past have taken 6mp, Prednisone and Remicaide

blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 1/2/2012 10:56 PM (GMT -6)   
Thankfully my boyfriend of eight years is here to take care of me. I can't even sit upright. I had an inconclusive colonoscopy in the spring, and will be sent back to the gi Dr once this infection clears up. I've had bowel problems for a few years, but had never been diagnosed before. I think I'm pretty tough, but this is like nothing I've ever experienced! I hate to feel like I'm whining, but I feel so bad. All the pills make me nauseous, but if I go more than 4 hours w/o a pain pill it feels like there is a knife stuck in my bum. I've got an emergency appt with my surgeon tomorrow, but so far his response has been "it's going to hurt." I expected pain, but nothing like this 5 days post-op. I wish he had never put in this drain, I don't know how I'm going to live with it for 4-6 weeks.

wednesday77
Regular Member


Date Joined Oct 2007
Total Posts : 349
   Posted 1/2/2012 11:38 PM (GMT -6)   
You might want to get a second opinion with another surgeon. I have had some horrible experiences where I look back and realize I was too sick to understand that responses like that are NOT OKAY. You are not whining, you have a serious medical condition that can cause unbelievable pain. Doctors and surgeons, as part of there job, are there to manage your pain. If he cannot do that then seriously get a second opinion - or ask him for stronger medication - we GET that it hurts, but to be in that much pain with no relief then you should either be admitted to the hospital, referred to a pain management center or have another doctor look at you. I've had some great doctors and some terrible doctors. My colorectal surgeon was the best of them all. He was so compassionate and kind and he really managed my pain well. He had me on morphine and oxycodine, and weaned me off depending on how quickly my recovery was going. I know they are afraid of people abusing the narcotics but *** are they there for when you have a painful, draining abscess up your ARSE?!? :)

Tell him the pain is unbearable and if he's still acting like that then call your insurance company and explain you need a second opinion and then go get one. Find a support group in your area and ask them who they go to. If you feel comfortable sharing on this forum the city or state where you live, or the closest major metropolis then maybe people can give you suggestions. I've had drs who are lazy and incompetent and it makes me so upset that I put up with it because I was too weak at the time to have the energy to do anything about it; I would just sit in the bathtub and cry from the pain. My heart goes out to you, I am sending you lots of healing thoughts!!

xo

blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 1/3/2012 12:04 AM (GMT -6)   
Thank you so much for understanding. I'm literally in tears now because someone gets it. I'll see what he says tomorrow, but I can't live like this, so I may need to fina another surgeon. This is all so overwhelming, thank you for being a voice of reason.

trickynikki
Regular Member


Date Joined Jul 2003
Total Posts : 471
   Posted 1/3/2012 3:40 PM (GMT -6)   
I had two perianal abscesses last spring, and they hurt like nothing else!! I know how you feel. I couldn't sit or stand. And I was pregnant so I couldn't lay on my belly either! I was on diloted as a pain med, and it helped a lot. I had drains for a bit, but they weren't efficiently draining the abscesses. I still have the seton bands that were put in at that time. Once the infection clears out the pain is so much more manageable. Definitely keep on your doctors about the pain. Good luck and keep us posted!

blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 1/4/2012 1:29 PM (GMT -6)   
Thanks friends. Dr upped my meds, so I'm hanging in there for now. Must have been doing acrobatics in my sleep b/c I woke up today bleeding and in horrible pain, but it seems to be under control for now. I do have a painful rash in the creases of my legs, almost like diaper rash...ever had anything similar? I put a little neosporin on it and am having a "pants free" day in bed which seems to help a little. Just waiting patiently for relief...

firecracker1
Regular Member


Date Joined Apr 2007
Total Posts : 208
   Posted 1/4/2012 4:53 PM (GMT -6)   
blankstare,

I had the same reaction as you. I had my setons removed after 2 weeks because of the pain. It ended up that I have pelvic floor dysfunction (muscle spasms) and the setons caused that to flare up. I know you said you have packing, but it could be pelvic floor dysfunction and the packing is causing that irritation. My dr said that it is common in those with Crohn's disease.

Also, the rash is like diaper rash. It's from the drainage from the fistula. Get a good diaper rash cream/ointment to clear it up. I hope you feel better soon.
Meds: Methotrexate injections 1x a week, zoloft, gabapenten.

Crohn's Disease with a failed seton placement for fistula, 2 perforations, 1 small bowel resection. Technically in remission, but still feel sick. Have joint pain, muscle pain, fatigue, nausea, D, and abdominal pain & cramping; recently diagnosed with Crohn's arthritis and gastritis.

Alisandra
New Member


Date Joined Dec 2011
Total Posts : 13
   Posted 1/7/2012 7:29 PM (GMT -6)   
oh poor you, I had my abscess 11 yrs ago and can still recall the pain, worse pain ever, i had surgery to drain it and then "packing" of the site for 3 mths, never experienced anything like it so my heart goes out to you. I lived on mash and gravy so passing stools was less painful and would soak in the bath before the packing was changed. as for pain meds I suggest you be discriptive in explaining-its like getting a very hard kick up the back side every 5 mins! Good luck and as you know with crohns it is only when you are well that you will appreciate how strong and amazing you were when you were sick.

blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 1/9/2012 2:55 PM (GMT -6)   
Heading back to the surgeon tomorrow. He increased my pain meds, so the pain is manageable with lots of sitz baths. I can't believe I still have this much pain 2 weeks post op.also made an appointment with my gastroenterologist tomorrow so he can check all the surgeon has done and verify that the fistula plug surgery is the correct next step for me. I would do just about anything to feel normal again. Going to try to go back to work this week, although I'm not sure how i'll sit for 8 hours. Fingers crossed all goes well at my appointments tomorrow, very nervous. Thank you all for your compassion and understanding!

neversurrender
New Member


Date Joined Jan 2012
Total Posts : 2
   Posted 1/15/2012 11:51 PM (GMT -6)   
blankstare. I know your pain friend. I was in Africa when I got my abscesses and couldn't come back into the states until a month later. The 15 hour plane ride back was one of the worst experiences I had to endure. Being by myself carrying a desktop computer, professional camera equipment and luggage and getting no sleep in pain and having to sit on my abscesses was so terrible. I had two large original abscesses on both sides of my bum. Had surgery to remove them, and one side healed over a year ago and the other I am still dealing with. Since my first surgeries where I had the abscesses removed they were packed by my mother (thanks God for her) with string gauze because it had to heal from the inside out. The bad side then required me to have a seton put in because it developed into a fistula which was causing the terrible pain before. This was then preparation for a fisutla plug which was a degradable plug which your body grows into. The fistula whole was left so it could still drain while it would heal. I thought everything was going fine until the pain never seemed to go away and I still noticed stool coming out of where the plug was put so it was a failure. Plugs usually work around 60% my doctor said so it was a risk to take. This procedure I remember was pretty rough on the pain scale. I finally got a cutting seton put in after the plug was gone and the fistula track was still there. I wasn't willing to go back into surgery so I actually endured this sober and awake which was a terrible experience with my doctor opening up my rectum and threading a cutting seton (rubber band) through the fistula. I would then go in every 2 weeks to have the rubber band tightened and it would cut through the skin making the fistula heal behind it and make the track smaller as time goes by which it eventually fell out.

Right now, I would say the cutting seton was the best procedure I could have done out of the 3, but it can cause older people problems of stool control because your muscles are cut through and there is a crevasse made. I however am pretty young at 23 and I have no health risks to affect it. The cutting seton did great, but I am still having problems of little random abscesses/infections buildling up in different areas around my old scar tissue. I have had to have them opened a few times which then heal up pretty quick. So I am just playing it by ear right now.

I am sure he ended up putting the plug in you. Let me give you some advice on how to take care of yourself and keep your head up:

1. Go buy powdered fiber. I use Konsyl Fiber Supplement. It does WONDERS! Take before or after every meal you take. DONT TAKE THIS DIRECTLY AFTER SURGERY due to being constipated from the pain medicine from the surgery. DRINK PLENTY OF WATER with this! This will keep your stool together and to where you wont have to wipe/getting in your infected areas. (http://www.sjunkie.com/wp-content/uploads/2011/10/konsyl-g.jpg)
2. Do not wait to see if you will heal over a long period of time. I recommend getting checked up fairly soon after your surgery. I waited a while after I got my plug and even though it wasnt working I still avoided going back right away which just caused more pain. Hopefully it works for you!
3. I see you are already taking sitz baths. KEEP TAKING THEM. They also do magical wonders to the healing process.
4. Get square gauze pads. I use all kinds but there are gauze rolls that roll out and you cut them and fold to put in your crack. This will help so much on keeping your lining between your legs dry and I would change these out alot. You will be having to buy alot of this stuff. (http://image.made-in-china.com/4f0j00ZeYEtwQGsubv/Gauze-Roll.jpg)
5. Keep clean! Eat clean! So important.
6. Don't lay down too much after surgery. You will get constipated very fast and the pain medicine in you will make it happen easier. Drink plenty of water!
7. Smile and be positive. My doctor and I have become good friends and he treats me as he would his son. He tells me stories of those he has to take care of that are dying and have much worse problems than I do. Trust me, this is the most painful thing I have ever had to experience, but I am alive and have come to realize that abscesses/fistulas are very emotionally and physically testing.
8. Try to get on a good schedule. Once you find some type of good schedule it will help out your social life and will help you stay positive about your situation.
9. Know that you are not alone. So many people have this problem you just dont hear about it. If you need to talk just respond here and I will bookmark this thread.
10. For your sitz baths get the liquid soap and put like 3 squeezes in to help sanitize the water.
11. Get a small mirror and check yourself and try to make sure nothing new comes up, if it does then IMMEDIATELY go to the doctor to get it checked on. As much as you hate going back for something new, YOU HAVE to go asap. Otherwise it could get nasty again.

wednesday77
Regular Member


Date Joined Oct 2007
Total Posts : 349
   Posted 1/19/2012 8:45 PM (GMT -6)   
Blankstare, how are you feeling? Any good news?

xo
Crohn's Colitis
35 year old female
DX 2006
Currently on Humira, Xanax for anxiety, multivitamins, extra Vit D and calcium
In the past have taken 6mp, Prednisone and Remicaide

blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 1/30/2012 9:21 PM (GMT -6)   
Thank you all for your advice and concern! The pain from the drain has finally become mild discomfort. Yay! I found a wonderful new gastroenterologist who has been running lots of tests and trying to help me get healthy. I go in this Wednesday to have a fistula plug surgery. A little nervous, praying the abscess doesn't return. My surgeon said even if the plug doesn't work, it usually makes the fistula smaller, and at that point he may be able to lay it open without risk of incontinence. I'll be out of work again, thank god my employer has been very understanding. Per neversurrender's advice, I'm stocked up on gauze and fiber. ;). My family doctor also increased my prozac and ativan doses, which has helped. My gi Dr switched me from prilosec to dexilant, it's great. This site and the support I've received from it has really helped me through so far, thank you all!

Crohnswifey
Regular Member


Date Joined Jan 2012
Total Posts : 70
   Posted 1/31/2012 10:24 AM (GMT -6)   
Well blankstare, we are all cheering for you! Hope it works for you, and you aren't in pain afterward! I wanted to share with you what Ivy6 shared with me. When you commented on my thread about my husbands issues, Im not sure if you saw the link Ivy posted but I found a lot of good advise from it. And I apologize, I am new to the site, so Im not very comfortable navigating around, but Im going to try and copy and paste the link to the help she gave me.

http://www.healingwell.com/community/default.aspx?f=17&m=1557968&p=1

hope that works.
and goodluck to you!

blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 2/6/2012 10:14 AM (GMT -6)   
Have I mentioned that I really don't like my surgeon??? Getting information from the man is like pulling teeth, so I guess i'll continue to get my info on here. I had the fistula plug surgery Wednesday, Feb 1st. Since then there is what I thought was packing from where my drain was. Feels like gauze to me... So I called the surgeon to see how Lo.g the packing should stay in (i don't go back until next week.). I always w.d up speaking to his nurse who is clueless and she sends messages back and forth. Ridiculous. So she says it's the plug and I should leave it alone.
Can someone else who's had the plug tell me if it feels/looks like a piece of gauze packing sticking out about 1/2 inch?

blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 2/14/2012 8:27 AM (GMT -6)   
I'm in so much pain again! I stayed in bed for a week after the fistula plug surgery praying it would take. I was down to a manageable level of discomfort and anxious to get back to my life. Then Sunday I had some severe itching around my anus. I used a little hydrocortisone cream and went to bed. Yesterday I woke up in some pain, took motrin, grabbed my heating pad and took to my bed. The pain has gotten progressively worse since then. I'm pretty sure I've got an infection again. I go back to my surgeon today and am hoping he can just put me on a round of antibiotics and pain meds. I am swollen to the point that the fistula plug, which used to protrude about 1/2", is completely inside me now. Has anyone experienced this, and to what end. I can't handle another surgery physically, emotionally or financially. So depressing. cry

txh2000
New Member


Date Joined Jan 2012
Total Posts : 6
   Posted 2/16/2012 12:43 AM (GMT -6)   
So sorry, blankstare. What did the surgeon say?

exit 4
Regular Member


Date Joined Apr 2009
Total Posts : 124
   Posted 2/16/2012 2:05 AM (GMT -6)   

I know how you feel! redface I had a
fistula plug surgery that did not work – it got infected and I ended up with
another abscess. Was put on strong antibiotics via IV and that stripped me of
all by good bacteria and caused c diff. My pain level was so bad only IV
morphine would help. Between abscess pain and c diff and active flare I was in
so much pain! Flagyl helped with c diff ( after 2 month’s c diff came back and I
had to start another round of Flagyl). Seton drain helped with abscess.  I practically lived in a bathtub for about 4 weeks. Take pain meds when you need them and do not be shy to call your docs if YOU feel something is wrong.


blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 2/16/2012 6:51 AM (GMT -6)   
The surgeon didn't seem too concerned, but he never does. Back on flagyl and percocet, which aren't coming close to touching the pain. On the bright side, I followed up with my gastroenterologist who is referring me to a specialist at university of Maryland. Praying she'll be able to get me some relief! As for now, I'm laying around with an ice pack between my legs 24/7.

blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 2/22/2012 10:43 PM (GMT -6)   
Well my friends, it appears there is more surgery in my future. I saw the colorectal surgeon today who confirmed my fears that the plug is not working and there is residual infection. So I go back in next Friday for an exam under anesthesia with sigmoidoscopy, placement of a seton, and possibly a partial fistulotomy to make the fistula shorter with the opening closer to my anus. Seton would stay in for 6 to 8 weeks, then she would do the LIFT procedure with biological film. Has anyone had success with any of these procedures? The doctor was very kind, which I needed, and was confident that she could get me my life back. Regardless, I've spent the afternoon crying and having a pity party. :(

Alex1830
New Member


Date Joined Feb 2012
Total Posts : 5
   Posted 2/23/2012 5:41 PM (GMT -6)   
i just had a fistulotomy done on tuesday. at first doc said there's a possibility that he might put in a cutting seton along with partial fistulotomy if it goes too much through the muscle. luckily during EUA, the doc found that the track is low enough to just do the fistulotomy. he found not only one but two fistulas. both were cut and laid open. i have been dealing with this problem for the last 5 months. now it's just a waiting game, making sure it heal completely.

blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 2/23/2012 9:01 PM (GMT -6)   
Oh Alex, I'm so sorry! I hope the pain isn't too bad and that your fistulas heal well. They are such nasty little buggers. My Dr said she can't lay mine all the way open as it goes too high, but maybe I'll be pleasantly surprised after my EUA. After the past 3 surgeries in 3 months I've had enough. I just started going to a highly recommended specialist instead of a general surgeon, so my hopes are high. Please keep me posted on how your recovery goes, it's nice to not be facing it alone!

jobell
Regular Member


Date Joined Feb 2012
Total Posts : 29
   Posted 2/23/2012 11:04 PM (GMT -6)   
Hi Blankstare: Well I feel like I'm related to you...lol. With that much pain I think what is happening with you is what happened to me at the beginning. I have feeling your abscess had burst and then of course is filling up again. With me during my first surgery (actually took 2 weeks of me returning to ER stating something was wrong) anyways don't want to relive that. Yes during the first surgery with the incision she made a gush of infection...the surgeon said she had never seen anything like that before....so natural she thought she had puncture the abscess...NOT! Went back again to hosp she just did a freezing and tired to pop the abscess with a pointed instrument. No go. So at this point I'm sent home again and actually thought I was going to die. Scariest thing ever! I could no longer walk.....the pain now climbed all the way up and down my spine. My daughter...my angel took me to another hosp where I was told to wait in the waiting room. the waiting room must have had 50 people in it. I'm in a wheel chair cuz I can't walk and of course don't want to be sitting on my bum...so my daughter helped me lay on the floor. Guess what I was put in a room just like that. So they have me on morphine which I tell them doesn't work on me but you can't tell the nurses that. The one of the interns comes in to stick her finger up my bum and I screamed...I can handle pain but that was torture. So they decide to rush me to surgery. Have the same surgery again. Of course the weeks go by and not very much infection is coming out...and I can actually feel the bacteria eating its way through my inside down there. So after 3 months of complaining to my dr's and 2 surgeons I get surgery again...guess what I now have 2 fistulas. So he put in 2 seton cutting bands. Woke up after the surgery and my beautiful daughter asks me why I have a black eye. ???????????? What the???? so call the surgeon the next day and with a chuckle states oh that must have happened when we had to cram a breathing tube down your throat. Nice. So the stage I'm at now is the tightening process for these seton bands.....oh wait yah went in on a thurs to have them tightened and he had found that the original knotting he had put in was gone......so I was more or less put back weeks in the cutting process. so with the nurse in the office he had to go inside the incision to retie and pull of the setons. Was send home with no pain meds...and was in sooo much pain for 2 1/2 days then I woke up to have a pee and found that both the seton bands had fallen out. What the hell!!!! so started having an emotional break down cuz the surgeon said I would return in 6 weeks to have them tightened. So I have an appt with him next week GGGGGGGGGGRRRRRRRRRRRR

So my whole point there was to maybe get them to give you an MRI with the radioactive dye...cuz that's the only way the found my fistulas and abscess.


June 2011 - My symptoms felt like I had 100 hemorrhoids, fever, major calf cramps at night.
July 7th 2011 - first surgery for perianal abscess with daily home care nurse to change packing....which never stayed in.
July 25th 2011 - Second surgery home care...no packing.
Sept 2011 - Colonoscopy ruled out crohns, colon cancer, polyps - since I have a family history
Home care nurse 3 times a week- mentioned to them that I thought I had a fistula
Nov 7th 2011 - MRI
Nov 30th 2011 - Surgery for 2 fistulas - seton banding (cutting)
Dec 2011 - Surgeon found bands not tied...retied.
Feb 16th 2012 - Surgeon founds bands untied...tightened and retied.
Feb 19th 2012 - Bands both fell out.

Post Edited (jobell) : 2/23/2012 9:40:19 PM (GMT-7)


blankstare
New Member


Date Joined Jan 2012
Total Posts : 12
   Posted 2/24/2012 4:44 PM (GMT -6)   
And now I'm getting a cold. :( Will they still do surgery if I'm sick?

Jobell- I'm so sorry for your pain, but it's nice to have another butt buddy!

Acern
New Member


Date Joined Aug 2012
Total Posts : 1
   Posted 8/18/2012 8:20 AM (GMT -6)   
Blankstare- hope you r doing better. I am joining the discussion a little late but glad I found this. It sounds like our situations are similar- pain, abbess, clueless general surgeon, nothing working

My background (short and sweet)- 26 years old, no history of gastro issues, had first baby vaginally Nov 2011, Dec 31 I rush to general surgeon in pain bc of abbess, surgeon cuts to drain, doesn't help, surgeon puts in seton plans to take out in 30 days, takes seton out fellas me open, cuts sphincter, takes forever to heal. Nothing is getting better, in between my ordeal I contract c diff. It's April, no one knows what's going on. Finally I go to a specialist for Crohns. They confirm the Crohns and said to mya surprise there r 2 different ways to handle a seton surgery (one for Crohns people)-- never cut sphincter on a Crohns patient.

This general surgeon didn't know any better and my pain and sickness was drawn out longer than it should have been, had it been done correctly I would have returned to work no later than mid Jan, I started back in March. Thanks to Remicade and an anti inflammatory pill the sickness has stopped, I'm feeling better, I can eat without fear of being sick. I do however still have drainage. The Crohns specialist sent me to a perirectal surgeon who did a scope and said I still have a small abbess. They are trying to treat with 3 months on flagel.

I wear gauze down there everyday. Some days there is a little puss, not much. It's getting better. But it hasn't stopped, I feel like I've always have to have the gauze. Every time I have a bowel movement I take a spray bottle to help clean the area and gauze. I feel like I'll never be free of that routine and things will not go back to normal. It has affected my sexual relationship with me husband. He has been very supportive through this hell. But we have a new baby, we're new parents, we both started new jobs, and all the while I've had 4 surgeries since Jan, diagnosed with Crohns and I'm still leaking pus out my bottom, it's gross. I don't feel like my sex life can not be saved until the abbess goes away, not so sure it ever will.

Glad to hear I'm not alone. I hate this but I'm dealing. Wondering how long before the Remicade stops working. Ive had 3 infusions. It's going well, would rather not do the shots in tummy.
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