Adhesions causing pain even after multiple abscess/fistula has healed

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Regular Member

Date Joined Apr 2010
Total Posts : 35
   Posted 4/21/2010 5:33 PM (GMT -7)   
Ok so since October of 2009 I have had three surgeries for abscesses and fistulas in the perianal area. The last one was five and a half inches deep (abscess) which protruded and adjoined to the back side of the soft penile tissue. The most recent MRI I had showed a fistula about the same length and possibly another fistula that butted up to my urethra. I have been in extreme constant pain lately and have been seeing a pain management doctor. I also have a ruptured disk that presses on the S1 nerve root. I still have an open lesion from the most recent abscess, but has closed in the area closest to the skin. I decided to get a second opinion since I have had so much trouble with this and provided this doctor with the most recent mri that was taken on March 31 2010. The doctor/colorectal surgeon didnt  even look at the mri, but instead poked at it with a probe and said based on what he saw from the outside that I didnt have anymore fistulas or pockets inside of me. This doctor told me that since he couldnt see anything from the outside that I must not have one and that I need to cease the pain medicine because I shouldnt be in pain. The funny thing is that all of these peri anal abscesses that I have had could not be viewed by looking at the area and could only be recognized with the previous MRI's. I will be going in for an updated MRI next Monday to see what progress I have made with the deep fistulas. The question I have is, would it be possible that I have adhesions deep inside of me that are still causing the pain, if for some reason the mri comes back clear? I saw this second opinion doctor only 2 weeks after the late march MRI so I highly doubt that these things have completely healed. Has anyone else faced this type of situation? I also can feel a hard knot like area that is next to my sphincter, so im not sure if this is somthing new or scar tissue.

Becoming undone
Veteran Member

Date Joined Jul 2007
Total Posts : 927
   Posted 4/22/2010 1:09 PM (GMT -7)   
Denolil82...Oh I totally understand...I truly believe there is something to what you say...cuz I feel that way too...I also sometime wonder if that sometimes the inflammation doesn't work outside 2 years ago, where I said my pain was horrible, it look clean on the it is inflamed, red, raw and angry...and I don't think my bottom has ever healed from the surgery 3 years ago...haven't been able to sit correctly since...
"The earth laughs in flowers"

Julia Hill
Veteran Member

Date Joined Mar 2008
Total Posts : 560
   Posted 4/23/2010 4:48 PM (GMT -7)   

Yes, I think scar tissue can cause pain. Also, I have had exploratory surgery for fistula's and abcesses in the past that were on the MRI and they could not find them. I was told it is like finding a needle in a haystack. It is very frusterating and sometimes seems like an endless cycle. Keep on it the best you can.


Regular Member

Date Joined Aug 2008
Total Posts : 37
   Posted 4/24/2010 10:03 AM (GMT -7)   
I too have a deep fistula that exits in a similar area. I had extensive surgery 6 months ago and to date I am healing resistant. Meaning I have an oversized fistulotomy trough stretching my entire perianal area that won't close. I have a seton in place - a band that goes through the former area of abscess and back to the surface - that keeps me from healing prematurely down deep and thus reactivating the abscess. As a result, I have no deep down abscess agony, but rather a lingering nasty surface wound to manage. Having developed an allergy to Remicade we are trying Humira as an option for healing the wound and I have had some modest improvement with fistular drainage going way down and the wound itself decreasing very slowly in size. So, I very much understand your situation.
I am unsure of some of your details. Do you have an active fistula with an external drainage site? From my experience, it sounds as if you have below surface fistula activity and that a tract is burrowing its way to freedom. If an MRI shows tracts how can a surgeon refute that? An external exam only identifies whether or not your fistulous tract has escaped the body? Have you tried Remicade? Good luck.
  • CD dx '86. Re-section '93. Dx Crohn's Colitis '98.
  • Participation in Remicade trials (fistulae) late 90's.
  • Manifestations of fissures, fistula, scleritis, polyarthralgia and erythema nodosum.
  • Presently on Imuran, Cipro, Flagyl
  • Remicade (2nd attempt - after 10 yrs - failed).  
  • Fistulotomy (Oct 2009) - failed miserably - now healing resistant wound tract (4+ months)
  • Humira (March 2010)

Regular Member

Date Joined Mar 2010
Total Posts : 186
   Posted 4/29/2010 12:32 PM (GMT -7)   
Yes, I do think that adhesions cause a good amout of my pain. My mom even drug me around the world ( literally- from Texas to Germany) for adhesion removal surgery. I had tons of pain all over my belly- from way up high to way down low. The surgeon over there uses some special tool and adhesion spray and I have talked to tons of people who had great success after his surgery. It sounds crazy and it was super scary but I think it was worth it. I have a j-pouch and I had a huge fear he would somehow puncture it so I asked him not to remove adhesions in my lower abd area and just in the upper stomach. I don't have upper pain anymore. Now- it I could only be brave enough to allow him to do the lower stomach I might have much less pain then I do now... but I am scared!
Dx with UC in 97, hospital stays monthly, tons of blood transfusion, bowel rest on TPN, prednisone, asacol, sulfa, imuran, VSP
99- multiple failed remicade treatments, more hospital stays
finally in 2001 had enough and had total colectomy (j-pouch) surgery, 1st step was good, then the reversal was not such a breeze, got peritinitis which was awful!!
the rest of 2001-2006 were amazing!
now having problems again- they are thinking Crohns.- have been on Humira with no luck

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