Questions about fistulas

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Bennie
Veteran Member


Date Joined Nov 2006
Total Posts : 552
   Posted 2/17/2008 10:18 PM (GMT -6)   
Is there anyone on right now (10:15 pm Eastern time) who might have some information about fistulas? Bratcat's brother has what is probably a fistula. Not sure where it is coming from. The doctor put him on Flagyl and Levaquin. Told him to try to take epsom salt baths. He started the meds on Thursday evening. He is supposed to see the doctor on Friday. Tonight he asked me to call the doctor tomorrow to see him because he thinks it may have gotten bigger (pain is still the same). He decided to take an epsom salt bath. Well something popped down there. He said there was pus. Now there is blood. And he is trying to stop the bleeding. Anyone know what to expect? Should the bleeding stop? Is this a good sign or a bad sign?
Thanks.
--Mom of bratcat (16 years old)--
bratcat was diagnosed with pancolitis October 2006
Current meds:
Asacol - 3 pills/3Xday, 2 tabs 6-mp/1.5 tabs 6-mp every other day
 
11/14/06 - started prednisone; 1/28/07 - finished prednisone!
3/3/07 - began to taper off hydrocortisone sloowwly! Summer 2007 - slowly began tapering Rowasa. 9/07 -- flaring? Nightly Rowasa. 9/21/07 -- added hydrocortisone enemas. 9/30/07--added prednisone. 10/31--started 6-mp, stopped the enemas. Started lowering prednisone.


BTC
Regular Member


Date Joined Dec 2007
Total Posts : 96
   Posted 2/17/2008 10:29 PM (GMT -6)   
Hi, I'm here in NJ - ironically, I think I'm havng something going on like that. There's some tissue and blood for the first time since I started the Pred - it's related to the rectum, I believe. No loose stools, just sore and some blood and tissue. I'm putting in a call to the doc for some suppositories. If he won't give them to me, I'm getting a second opinion. I've been so good, given up foods that I love and now this. I'm very bummed tonight. Hope things get better - did you call the doc?

suebear
Veteran Member


Date Joined Feb 2006
Total Posts : 5698
   Posted 2/17/2008 10:30 PM (GMT -6)   

It sounds, based on your description that he had an abcess and now it has fistualized (broken through). 

Sue


dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


malka
Regular Member


Date Joined Apr 2006
Total Posts : 171
   Posted 2/17/2008 10:33 PM (GMT -6)   
I had a fistula ten years ago in the midst of (or caused by) the worst flare I ever had. He should see his GI again. It sounds as if he might have an abscess if there was pus. If so, he needs to have it drained as well as antibiotics. A fistula isn't painful (at least mine wasn't). I also had an abscess about 4 years before that. It was very painful.

If it is a fistula, there are also medications that help close it up. I was on cyclosporine which made a difference. Since then (1997), infliximab has been used with success. In any event, he needs to see the doctor again.

By the way, I had been told that if you have a fistula and/or an abscess, it is a sign of Crohn's rather that UC. That is not necessarily so. I have UC.

M
Diagnosed UC 1975. 
Azulfidine Entabs 500 mg. 4 twice a day
Azathioprine 100 mg per day
Colocort - as needed
Folic acid, vitamins C and D, multivitamin, metamucil, fish oil, turmeric 
 
Hospitalized 1997 - intravenous cyclosporine.


Bennie
Veteran Member


Date Joined Nov 2006
Total Posts : 552
   Posted 2/17/2008 10:35 PM (GMT -6)   
Sue,

Is it okay that it "popped?" It is still pussing with a little blood, but he says he thinks it's getting smaller. I could have him sit in an epsom salt bath again but do you think it will "burn" from the salt?

Thanks
--Mom of bratcat (16 years old)--
bratcat was diagnosed with pancolitis October 2006
Current meds:
Asacol - 3 pills/3Xday, 2 tabs 6-mp/1.5 tabs 6-mp every other day
 
11/14/06 - started prednisone; 1/28/07 - finished prednisone!
3/3/07 - began to taper off hydrocortisone sloowwly! Summer 2007 - slowly began tapering Rowasa. 9/07 -- flaring? Nightly Rowasa. 9/21/07 -- added hydrocortisone enemas. 9/30/07--added prednisone. 10/31--started 6-mp, stopped the enemas. Started lowering prednisone.


pb4
Elite Member


Date Joined Feb 2004
Total Posts : 20577
   Posted 2/17/2008 10:42 PM (GMT -6)   
No it won't burn from the epsom salts, that's helpful for them...sounds like an abcess...

and yes, abcesses and fistulas are common to crohns not UC...UC and CD are not always DX properly, especially for those who have crohns-colitis which is when CD is affecting the colon like UC does, then it can be even harder to get a proper DX and believe me, there are CDers out there that have had ONLY their colon/rectom affected by crohns, not every CDer gets CD in other parts of the GI tract.

Usually that's why when a UCer has problems with fistulas or abcesses it's a good indication they may have been misdiagnosed.

:)
My bum is broken....there's a big crack down the middle of it!  LOL  :)


Bennie
Veteran Member


Date Joined Nov 2006
Total Posts : 552
   Posted 2/17/2008 10:46 PM (GMT -6)   

So should I try to get him back into the bath?
He says it is slowing down a bit on oozing. If he can get it to stop for the night, I will call the doctor first thing in the morning.


--Mom of bratcat (16 years old)--
bratcat was diagnosed with pancolitis October 2006
Current meds:
Asacol - 3 pills/3Xday, 2 tabs 6-mp/1.5 tabs 6-mp every other day
 
11/14/06 - started prednisone; 1/28/07 - finished prednisone!
3/3/07 - began to taper off hydrocortisone sloowwly! Summer 2007 - slowly began tapering Rowasa. 9/07 -- flaring? Nightly Rowasa. 9/21/07 -- added hydrocortisone enemas. 9/30/07--added prednisone. 10/31--started 6-mp, stopped the enemas. Started lowering prednisone.


suebear
Veteran Member


Date Joined Feb 2006
Total Posts : 5698
   Posted 2/17/2008 10:48 PM (GMT -6)   

Yes, he should be fine now that it popped but he does need to follow up with a GI or a CR surgeon.  Although fistulas and abcesses are more commonly found with CD patients, this does not mean he has CD.  about 20% of UC patients will develop an abcess or fistula.

Sue


dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


Bennie
Veteran Member


Date Joined Nov 2006
Total Posts : 552
   Posted 2/17/2008 11:05 PM (GMT -6)   

Can you tell the difference between an abcess and a fistula? I understand the difference on paper but is it something a regular person can tell?
Also, do you think it is wise for him to wear a sanitary pad tonight? (He brought it up tongue ) This way if anything leaks, he is protected. Or will it irritate it more (or be unsanitary).

Again, thanks for helping. It's great having such a strong support system here.


--Mom of bratcat (16 years old)--
bratcat was diagnosed with pancolitis October 2006
Current meds:
Asacol - 3 pills/3Xday, 2 tabs 6-mp/1.5 tabs 6-mp every other day
 
11/14/06 - started prednisone; 1/28/07 - finished prednisone!
3/3/07 - began to taper off hydrocortisone sloowwly! Summer 2007 - slowly began tapering Rowasa. 9/07 -- flaring? Nightly Rowasa. 9/21/07 -- added hydrocortisone enemas. 9/30/07--added prednisone. 10/31--started 6-mp, stopped the enemas. Started lowering prednisone.


princesscolon
Veteran Member


Date Joined Apr 2006
Total Posts : 733
   Posted 2/17/2008 11:18 PM (GMT -6)   
From what I have heard on the CD forum, people wear gauze over the abcesses so a pad should be ok. I would double check on the CD forum.
Diagnosed with Left-sided Ulcerative Colitis 1995 at 15, Tried: Prednisone, Rowasa & Hydrocort. Enemas, Proctofoam, Sulfasalazine, Asacol, Probiotics, Fish Oil, Canasa, Enotcort, Colazol, Anamantle, etc... had almost recto-vaginal fistula in 2004, put on Remicade, August 2007:Increased Remicade dosage-700mg every 6 weeks,diagnosed w/ Psoriatic Arthritis & Fibromyalgia Current meds: Remicade 700mgs every 6 wks (had reaction, will start Humira Feb 11) Clorazepate, Proctofoam HC, Glucosamine 500, Vitamin B, Lomotil,  Tylenol pm, Lyrica for Fibromyalgia started 1/17/08


Bennie
Veteran Member


Date Joined Nov 2006
Total Posts : 552
   Posted 2/18/2008 12:39 AM (GMT -6)   

Thanks for all the answers and support. My son bathed in the epsom salt bath again. It didn't hurt. He was still leaking after so he is wearing a pad to bed. Got to love a kid who doesn't complain about wearing his younger brother's boxer/briefs and a sanitary pad. The whole ordeal wiped him out so he went to bed. He said it still hurts a lot but not the same pain as during the day. More so because it "popped". He thinks the abcess is a bit smaller. I'll call the doctor in the morning.

Have a good night all.


--Mom of bratcat (16 years old)--
bratcat was diagnosed with pancolitis October 2006
Current meds:
Asacol - 3 pills/3Xday, 2 tabs 6-mp/1.5 tabs 6-mp every other day
 
11/14/06 - started prednisone; 1/28/07 - finished prednisone!
3/3/07 - began to taper off hydrocortisone sloowwly! Summer 2007 - slowly began tapering Rowasa. 9/07 -- flaring? Nightly Rowasa. 9/21/07 -- added hydrocortisone enemas. 9/30/07--added prednisone. 10/31--started 6-mp, stopped the enemas. Started lowering prednisone.


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 2/18/2008 9:11 AM (GMT -6)   
Remember too that abscesses and fistulas can occur in the absence of IBD. Sometimes it's a chronic infection of the perianal glands that leads to fistula formation. Let's hope this is what's going on with your son, Bennie.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Asacol, Rowasa, Pentasa, Prednisone, Entocort, Azathioprine
Colazal,  Remicade, Nature's Way Primadophilus Reuteri.
In remission since April, 2006. Remicade has been my wonder drug.
 
Co-Moderator UC Forum

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