abcess to fistula?? what do you know?

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Regular Member

Date Joined Jun 2006
Total Posts : 139
   Posted 5/19/2008 5:53 PM (GMT -7)   
 I have had Crohn's for over 17 years and had two resections (all right side-terminal il. area) and am now dealing with something totally new!  I had an abcess totally out of nowhere--had it drained @2 weeks ago and it is still infected.  I am on a second round of antibiotics and had it opened and drained again in the colon-rectal surgeon's office today.  He brought up the "f" word-fistula!  I go back again in 2 weeks to see if it is improved or to talk about further treatment (O. R.). 
I am a former Remicade and Humira user (last dose was March 07) because I had a resection in June '07 and was declared Crohn's free at the time.  I am still on 75 mg. of  Imuran a day to keep me in remission status.  Hmmm . . . do you think this out of remission or just rotten luck???
Ugh!!!!  I have been reading the previous posts and learned a lot  about the abcess end of it, but a fistula in the near rectal area is totally new to me.  My disease has involved fistulas in the small intestine.  I never thought I would be dealing with this area (rectal). 
For those of you have had surgery for the abcess- turned- fistula, what is the true recovery time?  Did you heal completely eventually?  Was the surgery enough? 
I would appreciate any input!  This has really just thrown me for a loop!

Veteran Member

Date Joined May 2007
Total Posts : 1220
   Posted 5/19/2008 6:18 PM (GMT -7)   
Hi Patty,

There areseveral people here that have per-rectal abscesses, fistulas and setons. There have been quite a few posts a month or so a go. I suggest you search a while back.

I have 2 fistulas that start in my rectum and empty out in the perineum (between the rectum and the vagina). I have setons in them to keep them draining. Treatment of rectal fistulas is almost always by surgery, but some (like mine) are too high in the rectum. Too much sphincter muscle would be cut and I would be immediately incontinent. I'm allergic to the drugs that might shrink the fistuals without surgery (remi and humira), so I must live with them.

I hope your colo-rectal surgeon has experience with CD. Please do not let anyone with little experience with CD get anywhere near you!! This is critical!! Many colo-rectal surgeons have experience with rectal abscesses and fistulas (they actually are common) BUT they need to know CD too. Otherwise that may perform surgery that won't heal. We just don't heal they way others do.

The best way to diagnose a fistula and treat an abscess in a CD person is to take you into the OR. A seton will be placed if a fistula is found. I felt better almost immediately after getting the setons. The fistulas kept closing and infection was building up -- this can become septic!! If it is a fistula, you will more than likely be put on Remi or umira for the long-term.

You say it is still infected after 2 weks. Honestly, I wouldn't wait any more time. I'd call and get an OR appointment ASAP. The sooner this is dealt with the better!!!

Let us know what happens! Take care!

Veteran Member

Date Joined Mar 2006
Total Posts : 2739
   Posted 5/19/2008 8:58 PM (GMT -7)   
I've had a fistulotomy, where they open the track and let it heal from the inside out. It took quite a long time to recover. about a year actually. Now it wasn't painful for the entire year. Really the only first 3-4 days was quite uncomfortable. After that it was just a healing wound for a year. Lots of soaking in the tub! But yes, it did completely heal and I haven't had any more problems with it.
Diagnosed with Crohn's Disease 2/06 after sever GI bleed. Has been suffering since 1998. History of rectal fistula and gallbladder removal. Currently taking Prednisone: tapered to 35 mg, Asacol, Questran, Toprol XL (for high blood pressure).

Regular Member

Date Joined Jun 2006
Total Posts : 139
   Posted 5/20/2008 3:19 PM (GMT -7)   

Thank you both!  I go back in two weeks and really don't have time for this right now!  Of course, no one does!  But school is about to end and I am a teacher!  In 2 and 1/2 weeks I will be more ready to resolve this if needed. I feel better being back on antibiotics and he redrained it yesterday so that has made some difference.

My doctor does work with Crohn's patients and explained how the surgery would be different because of the Crohn's.  I guess I will wait and see if the remicade or humira are back in my future! 

Thank you for sharing your stories.  I did read many past posts, but you both gave me additional insight!  Jen--I am crossing my fingers and hoping that if I have surgery it goes as well as yours! I can't imagine having two of them Fall Colors!  Oh, my!


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