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Need help with abscess found on MRI

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Crohn's Disease
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billo
Veteran Member
Joined : Mar 2006
Posts : 577
Posted 12/17/2018 4:16 PM (GMT -7)
they said they found a .9 centimeter abscess and will treat with antibiotics and possible surgery. Dr. also said antibiotics don't heal the abscess just prevent it from spreading.

A couple of things:

a) in the past, doctors treated my abscesses with antibiotics and no surgery
b) if the above is true, how come those previous abscesses didn't show up on the MRI?
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73monte
Veteran Member
Joined : Mar 2007
Posts : 2254
Posted 12/17/2018 5:33 PM (GMT -7)
Not sure about you previous abscesses. Could have been operator error, or not read properly? As far as the treatment, some abscesses are impervious to antibiotics, due to the outer skin. Did they talk about doing a CT guided drain? Then once opened and draining the antibiotics should do their work.
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EbruNink
New Member
Joined : Aug 2018
Posts : 5
Posted 12/18/2018 12:31 PM (GMT -7)
Your doctor should not prescribe you antibiotics unless the abscesses are skin-related (boils, HS) and you're on immunosuppressive meds. Antibiotics do not work for abscesses and they should be surgically drained, even when smaller as they could cause systemic symptoms like fever and muscle pain. You should not rely on MRI's for such serious things, I had an abscess not showing up on MRI either.
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billo
Veteran Member
Joined : Mar 2006
Posts : 577
Posted 12/18/2018 1:19 PM (GMT -7)
Nink, are you sure? I've had 2 previous abcsesses and my normal GI prescribed antibiotics. This time a different doctor prescribed THE SAME antibiotics for a new abcsess. I'm not trying to be a jerk, but doctors (GI's) know more about this than you.
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wednesday77
Regular Member
Joined : Oct 2007
Posts : 450
Posted 12/18/2018 3:31 PM (GMT -7)
Same, I've had 2 previous perianal abscesses and they had to be surgically drained both times - antibiotics alone don't work because they can't reach the abscess. My GI drs also usually prescribe the same antibiotics because Crohn's patients tolerate a few better than all the others. The last time they also thought they saw a fistula on the CT scan but it turned out it wasn't there so maybe they read the test results wrong? Regardless, in my experience an untreated abscess can trigger a Crohn's flare for me so if you aren't getting sick then maybe antibiotics alone are working for your situation but across the board abscesses generally need to be drained then a course of antibiotics. If that is the case for you then at least know you it often alleviates the pain and the surgery isn't bad. Good luck!
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scifigal2k
Veteran Member
Joined : May 2012
Posts : 3590
Posted 12/18/2018 4:34 PM (GMT -7)
Yeah, and the risk with frequent antibiotics is getting c. diff. They also cause me to flare. I've had two different abscesses that both were surgically drained. The second one caused me to be septic.

Treatment is going to depend on a few things:
- Where is the abscess located, and how deep is it?
- What current medications are you on to control your Crohn's?
- Are there any fistulae that could be causing frequent abscesses?
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