It's possible to get abscesses/fistulas as a UC sufferer, right?

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Date Joined Mar 2010
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   Posted 1/13/2018 4:14 PM (GMT -6)   
I lived overseas for ten years where I was diagnosed and re-diagnosed with UC via biopsy (IIRC) in two different countries. I was also diagnosed with ulcerative proctitis back in 2004 or so.

Since I moved back to Canada, my doctors are convinced I have Crohn's simply because I got an perianal abscess (in the right butt cheek) that needed to be drained. While the doctors here seem 100% sure that it's Crohn's, they haven't diagnosed me in Canada yet. My doctor in Korea, however, is 100% certain it's UC because they did diagnose it there (more than once I believe) and I tend to trust him because I've been admitted there before and they know me inside and out.

Not sure what to think.

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Date Joined Aug 2012
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   Posted 1/13/2018 5:13 PM (GMT -6)   
Somebody said...
Incidence and management of anorectal abscess, fistula and fissure, in patients with ulcerative colitis

Summary and Conclusions
During a survey of 465 patients with ulcerative colitis, it was learned that 82 (17.6%) had one or more anorectal complications such as abscess, fistula-in-ano, rectovaginal fistula and fissure-in-ano. These complications were associated with attacks of colitis, which generally were severe.

The incidence of fissure-in-ano was significantly greater when colitis was extensive, but that of abscess and fistula varied little with the severity and extent of the disease.

All complications occurred most frequently during the year of the first attack; after this the duration of symptoms of colitis had little effect on the incidence of anorectal complications.

Treatment of each complication is discussed. Perianal abscess requires immediate incision and drainage. Six cases of spontaneous healing of fistula-in-ano are described. Rectovaginal fistula required excisional surgery. Fissure-in-ano was treated by symptomatic measures alone.

It is emphasized that treatment of these complications must be accompanied by vigorous treatment of ulcerative colitis itself.

Source: /
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Date Joined Feb 2011
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   Posted 1/13/2018 6:55 PM (GMT -6)   
You can have UC and get a fistula. But the line between CD and UC is sometime not completely clear for some patients.

Often the diagnosis does not have a large effect on what drugs is tried - although a few are only approved for one or the other. Mostly the diagnosis decides if you are a surgical candidate or not.

I would not sweat the CD/UC question unless it becomes more pertinent to your care.

good luck
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Date Joined Dec 2008
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   Posted 1/13/2018 9:03 PM (GMT -6)   
I rarely see people here with fistulas who have UC. I knew one person who had surgery, and she wasn't a candidate for a j-pouch, because of a fistula. She ended up getting pathology during surgery and the pathology said UC. Have you seen your pathology reports? You should request them.

It's true that treatments are the same. The big reason to differentiate is if you need medical options that are open to one IBD and not the other, or if you were considering surgery.
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   Posted 1/14/2018 7:43 AM (GMT -6)   
I have UC (probably) and had an abscess that became a fistula. According to my GI, and now the article provided by iPoop, people with UC are more likely to suffer from abscess and fistula than the general population. Any person who develops an abscess has about a 50% chance of that abscess becoming a fistula, regardless of whether or not they have IBD.

When I originally went to my colorectal surgeon for my abscess, he said he rarely sees abscesses in UC patients, and to keep it in the back of my mind that it is possible that I have been misdiagnosed, and actually have Crohn's. Later, when I saw him again for what was now a fistula, he changed his tune a bit and said because the fistula was high (12 o'clock position) that this does not necessarily indicate Crohn's. He said Crohn's patients tend to have lower fistulas and he treats non-ibd patients with fistulas in the same spot as mine fairly regularly. I don't know what to think after those contradictory statements, but I understand your desire to know for sure. Both my CRC and GI are sticking with the UC diagnosis. I'd like to know whether or not I am a J-Pouch candidate and if I can be "cured" by surgery if it ever comes to that. The article iPoop linked to says approximately 17% of UC patients develop abscess/fistula. My guess is, within that 17%, are a number of patients who are misdiagnosed. Just how many is anyone's guess.

Old Mike and Michelejc who are regular contributors here have also dealt with multiple abscesses. There have been others as well. Some have "graduated" to the Crohn's forum.
Diagnosed Proctosigmoiditis (UC) February 2015
Current Meds: Lialda 1.2gm 2x daily, duloxetine, rowasa as needed

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Date Joined Jan 2010
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   Posted 1/14/2018 1:38 PM (GMT -6)   
As if my first UC flare wasn't bad enough, it was accompanied with a perianal abscess. I wouldn't have wished that on anyone. My bathroom became a torture chamber with each bowel movement, about 15-20 a day, feeling like I was excreting shards of glass. I have had flares since then but once the abscess was taken care of it never returned.
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