perianal abcess? meds?

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crohn's pt mom
Regular Member

Date Joined Nov 2008
Total Posts : 86
   Posted 2/27/2009 1:31 PM (GMT -7)   
I've been reading some posts, and it seems these things are hard to heal.  My daughter has 3 c-ton drains in and has been having to wear sanitary pads since July'07.  The 2nd and 3rd drains were put in a week ago.  She got sick on Flagyl and I just called the dr to see if he wants to put her back on Cipro.
Did I read that antibiotics are not always the answer? someone mentioned that the abcess has to be cleaned out which is what the surgeon did last week. 
What meds are out there to help heal this abcess, at this time she doesn't have any other "crohns" symptons (so used to freq bms feel its normal).  She's on Lialda, B-12, Probiotics, and will probably go back on Cipro. 
The other meds I see out there like Humira or Remicade, what symtoms or crohns issues do they address?  Is it the c and d and abdominal discomfort or will it help with the abcess and fistula?

Veteran Member

Date Joined May 2007
Total Posts : 1220
   Posted 2/27/2009 4:29 PM (GMT -7)   
I don't know where her abscess is or how deep. I can only say what my colo-rectal surgeon told me which is that I&D is needed for peri-rectal abscesses . Incision & Drainage means slicing it open, scaping it out, and letting it heal. This is different from just draining and flushing/irrigating, which my doc says is not as successful in CD patients as I&D. The important thing is that you are seeing a colo-rectal surgeon that knows CD. The fact that she has setons is s good sign, so I must assume what the doc did was the best treatment.

Antibiotics post-procedure are used to kill infection that may be in the tissue surrounding the abscess. Once the abscess is gone, the infection should clear in a matte rof days. If she gets a fever or starts to feel unwell, call your doc right away.

Once the abscess heals, you are still left with the fistulae and setons. The setons will continue to keep the fistulae open so they can drain (rather than abscess). That is what they do. If you can get the diameter of the fistulae to shrink/narrow, then the drainage will be less. The biologic drugs (remi and humira) can shrink fistulae as well as reduce CD inflammation in general. There are lots of people on these drugs.

I hope the abscesses go away for good!
Diagnosed with rectal 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.

Regular Member

Date Joined Jun 2006
Total Posts : 83
   Posted 2/27/2009 5:20 PM (GMT -7)   
I had a fistulae a few yrs ago that would not heal. At that time there were no true colon rectal Surg.'s in my town. A very good general surgeon tried two procedures that failed and as we all know, fistulaes do not heal easily with Crohn's. The Surg. sent me back to my GI and he started me on entocort ec,
6 mp for about 3 months and then began the Remicade. I was very lucky, as soon as I started the Remicade the fistulae healed quickly and I remained in great shape for about three years. Scar tissue began blocking me so a resection took care of that. Now the GI took me off all meds and 6 months later a fistulae started to reappear. He put me back on Remicade only but this time the Remicade didn't work. I was told in the begiinning that Remicade only works for about 4 out of 10 people. Then we tried the Humira and I had to stop that due to C Diff. Once the C Diff was taken care of we started Humira again and I threw two small blood clots to a lung. Stopped Humira again. (I don't think Humira is to blame but I'm shell shocked and refuse to take it) haha.
So now we have a true Colon Rectal Surg. here now and he installed a Seton and told me once all the inflamation is gone and Crohns is in remission, he is going to try a Fistulae Plug. I'm currently taking 6 mp and the Flagyl made me sick also so I'm just trying the hot sitz baths for now. Good Luck and if you guys go the Remicade route, I hope it works.
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