Anorectal abscess and drain

Hello, I have had a anorectal abscess for a couple of months.  I was told that there is also a fistula/fistulas. I am not really sure if the Surgeon I saw just assumed that because of the crohns or actually knows that there is a fistula. When I first saw him he pushed on the abscess and it would drain a little which seemed to coming from the rectum. He sent me home and told me to soak 3 times a day for 15 minutes and push on the abscess so it will drain. After a couple of days the abscess got big and I was in A LOT of pain. I went back to his office and he made a incision and he said a lot of stuff was draining out (he actually seemed very shocked about how much was draining out).

Well it's been over a month and I still feel the hardness of a abscess and the incision is still open and draining. I don't know if this is normal or if it is safe. It usually drains and is yellow in color but the other night I woke up and it was bloody/rusty in color and a lot on the pad (which I have to wear all the time). I felt warm as if I had a fever and took my temp. and all day it stayed at about 99.3. The abscess feels like it is almost in a U shape. My concern is that the incision is still open and I still have drainage after a month. Is this ok? I was on flagyl for over a month and then taken off that and was just put on Augmentin (I am allergic to Cipro). I am worried that this infection can get into my blood stream and i will get very sick or can even die. Has anyone had a Seton drain put in? If so was it very painful? After the drain was put in how long did it take before you felt pretty normal again? Anything someone can tell me about their experience i would really appreciate. Also, which drain is the least painfull? I know thw surgeon mentioned a seton drain but from some of the stuff i have read there are different ones.

 

I am having a lot of diareah from taking the augmentin since I started 4 days ago. My old GI doctor told me he wouldn't see me anymore because I am to scared to start Remicaid so I am looking for a new Doctor. I had a appointment in Mt. Sinia hospital (clinic) in manhattan last friday and the doctor seemed very good but because I suffer from anxiety and panic attacks being in the city was so overwhelming for me and I had panic attacks all night. I am so nervous about everything that is going on that my anxiety and panic is taking control of my life. I started suffering from anxiety and panic attacks over 10 years ago when my father passed away but for the last 5 years got much better, now because of this abscess and worring about getting surgery to put a drain in I am suffering so bad again from anxiety that I can harley leave my house without having panic attacks. I haven't been able to sleep in over a month because about every 50 minutes I wake up with my heart pounding.

 

I am really scared and It the anxiety/panic is taking over me. I have 5 beautiful kids that I need to care for but because of the anxiety about what will happen with this abscess/fistula I can't do my job as a mother. My husband is wonderful but because he just started a new job he is not going to be able to take off from work if/when I get the surgery (he already spoke with his boss). We don't have any family to help us and this is becoming so hard.

 

Is it safe for it to just drain from this incision? The new GI doctor that i saw last friday is the one who put me on augmentin and told me if it didn't agree with my stomach I could stop taking it. I can't stop going to the bathroom since I started and I don't have a appetite. I'm scared to stop it though because i don't want to get a infection. I am also taking Entocort (since January), 3 pills every morning and he said I should come off of that. He said i can just stop taking it or if i felt better to wheen off. he said it was ok to just stop taking it but I am to scared to do that. Has anyone ever just stopped? I am also on asacol, 3 pills 3 times a day. In a little over a year I have lost 50 pounds and can't afford to lose one more pound. It's hard though because with the anxiety being so bad from being scared I feel sick because I am forcing myself to eat. I believe if I can get through this whole thing with the fistula/abscess the anxiety will calm down (as long as I am not in a lot of pain). I am so scared of so many things: I am scared to be put to sleep for suregery, I am scared of the pain after, i am scared of pain meds (the only thing I take is extra strentgh tylenol). I don't want to be on anything addicting or anything that will make the anxiety worse. I already take Xanax (which is addicting) everyday (for years) for the anxiety and it has got so bad that the xanax isn't helping anymore.  

 

I am so sorry that this is so long. I also know I didn't put everything in here. I am really just freaking out and if anyone can help me I would really appreciate it. I am so sorry if I am all over the place in this post, I just have so much on my mind.

Sorry to hear about your problems.

A head GI said that the abscess is from Crohn's. The fistula probably is too. They may not start you on any biological drugs because the abscess can get worse.

I have an abscess in my sigmoid colon and then about 2 weeks ago I had a perianal abscess cut open. It hurt worse after it was cut open for maybe a week. I used a heating pad and baths to make it drain afterward.

I had my first Humira shoots today, and it seems like the area that had the abscess is sore and bulging again. I am not sure if it was from Humira or because I sort of stretched my leg out yesterday and then the area of the abscess hurt really bad, as if I had opened up the wound more. I will probably go to the ER if it does not go away in the next few days.

It sounds like you have perianal Crohn's. The head GI was saying that Remicaide and Humira will work for it. Looks like that is your next step.

dont guess, have some understanding of the meds you take and for what it is for. I responded to your post and suggested you ask the doc about why your heart races and apparently you feel it is because of anxiety. I dont like the idea of not having any back up from the doctor about it, so again you should find out why from your doctor. As far as getting off augmentin, unless there is some allergic reaction, I did not suggest to get of the antibiotic. Actually I suggested it might help. However it is similar to penicillin, but if you did not have a severe allergic reaction, then you are supposed to take it for the prescribed time period. I think you need to decide with the doctor for the medical regimen as I can only offer advice. Not taking your medications with an abscess, however, is not a wise idea.

I am a new member and can completely understand where you are coming from. I have had Crohn's since I was 17 years old and am now 33. I had a terminal ileum resection in '94 and other than that have not had to undergo any further operations...until now. Last year I began having a perianal abcess come and go and had to have many incision and drainages at the surgeon's office. I had this done the first year I was diagnosed with Crohns but it had been "dormant" until last year... Finally, on October 12th ( a few weeks ago) and after much hesitation and fear, I had a partial fistulotomy with a Seton drain placed. And, after years of trying to avoid Remicade, I was forced to come to terms that it is my only option now to hopefully close the fistula. I have had two treatments and have done very well so far with the Remicade. They hope to see closure of the fistula after my third infusion and hope to pull the seton at that time. If it returns, then I will have to go through this again and might have to have a cutting seton. I will be honest and tell you that the surgery hurt...I would rather have had an abdominal surgery or a million c-sections over this...and I am still in pain and having to take more pain medication than I did before the surgery.  I only tell you that because I wish someone had told me so that I wasn't so hard on myself. I had read so many posts that peolpe were not in pain and it made me feel awful like I had a low tolerance for pain after all these years. But, after speaking with the surgeon, he said it was a very large fistula that he had to remove and could only remove part of it to preserve my sphincter and avoid fecal incontinence. It still hurts and although the Seton is not as "noticable"  I still feel it and am uncomfortable. The pain has been very bad recovering, a deeper pain like before I had the surgery and I am still not back at work. The surgeon told me this pain was to be expected because the area is so tender and as he said " I would not want to have done to me what I had to do to you". However, even after all this, I do recommend having the Seton if the abcess continues to reoccur. I have cried and wished it was out of me but I see the drainage and know that this is my only option right now. I have a 2 yr old little boy and I did have my family help me with him the first week after the surgery. Please let me know if you have any other questions and I can try to just be there to listen to you if you need that. Good Luck with your new doctor. I trust mine with all of my heart and it is the one thing that reassures me when things get bad...

My heart is going out to you after reading your post, I'm so sorry things are so difficult at the moment - and a doctor who isn't very understanding or sympathetic is just hellish.  I'm glad you've found a better doctor to help you, but this has clearly led to another problem because you need to travel into the city.  That said, if the doctor does seem like a good one, and could be good for treating your Crohn's, I'd stick with them - a good doctor really makes all the difference.

Is there somewhere local you could go for support for your anxiety and panic attacks?  If you could get some help for that (and I'm sure it'll help in dealing with your Crohn's too) it'll mean you don't have to forsake a good doctor.  My brother has terrible anxiety, and like you hates going into busy and noisy places or even travelling too far from home.  One of the techniques he uses is wearing headphones with some soothing music when he's in busy cities etc.  It just helps that little bit with drowning out some of the noise.  Another thing he does is relaxation techniques at home but uses a scented oil while he's doing it.  His brain begins to make the connection between this smell and a feeling of calm.  He says it's very difficult to focus on his relaxation when out and about, so he pops a little of the oil under his nose - and it just gets him quicker and easier into a better head space.  Also, something that he says is, journeys and visits to places come a little easier over time.  Once he's done it a few times, he finds the general familiarity of it offers some comfort too.  But I know it isn't easy it's a real issue, but giving up on a good doctor may be as bad in the longer term.

As for the abscess, now that's something I unfortunately have had too much experience with.  I've suffered with perianal crohn's and abscesses continually for 9 years, and if you've not had one before and not sure of the treatment procedures or options - it's extremely daunting.  You need a meeting with your doctor to discuss you concerns and questions (prepare a written list and take it with you - and don't be afraid to write what they tell you down).  Talk about your worries about it healing, how it's draining etc. and what treatment options are open to you.  I can only tell you what I found to be the best for me, but it may help you to form some questions for discussion and what would be good for your situation.

If it's an abscess that has formed with NO fistula (that's no tunnel through into your bowel or rectum), then in my experience an 'incision only' doesn't heal very well, and the skin around where it was ends up hard and sore and intermittently refills and drains agains.  My surgeon takes the whole abscess away - I've had holes as large as small grapefruits (and I'm not exaggerating!) but they don't have to be that big so don't panic!.  Any bit of the flesh that was affected by the abscess is excised.  It then gets packed and covered everyday.  It heals from the bottom of the hole upwards - and it's surprising that it doesn't actually leave as big a scar as when they just put a little incision in them and infact, it heals quicker.  Admittedly, it is sore for the first week - nothing that can't be handled with painkillers though and not as bad as the original abscess - and then after that it gets a lot more comfortable.  When only a slit is put in them, they never heal as well, they're always sorer, the scarring is worse and the problem recurs every so often.  A full removal sounds so more drastic I know, but when my Surgeon recommended it, I went with it, and he was so right.

However, if there is a fistula, and the doctor recommends a seton, that sounds like good advice to me.  I had two abscesses that fistulated into my rectum and setons were put in.  They're a little uncomfortable at first (but again, nowhere near like having an abscess).  This means that the fistula can keep on draining, so that the skin wont heal up and an abscess reform.  The idea is to keep it open until the medicines can work and get your crohn's under control and start healing the fistula.  If that can be healed up, the seton can be removed.  It also may enable you to go onto Remicade treatment if appropriate.

Which leads onto the next point, the Remicade.  I was to have it a while ago, but because of my abscesses, I couldn't take it.  But I'm being effectively treated for them now, I don't want to tempt fate, but the situation seems to getting undercontrol.  I've been told that I should be able to go on it soon, and, like you, I've got my concerns and reservations.  That said however, I'm willing to give it a try.  I've been ill for too long, and for me, this is my last treatment option.  Discuss everything with your doctor, it may be that other treatments could be given first before even thinking about Remicade.  It really should be one of the latter options, rather that one of the first.

I took Cipro and Augmentin together for 8 months (and yes, Augmentin does make you feel very sick at first, but it does get better).  I'm now on Azathioprine immunosuppressants and Clindamycin and Rifampicin antibiotics.  My Crohn's is being beaten down with the Aza and the abscesses are clearing with the antibiotics, as soon as I'm clearing up they'll get the Remicade in and, fingers crossed, knock the darn thing down to a liveable level.  Everyone is different, it's just trying to find the right line of attack that works for you - and a good doctor will know this and not assume that one treatment approach fits all.

Sorry for waffling on, but I wish you all the very best of luck and hope things work out well for you.

Lots of Love

Sweets

xxxx

There is no pain like that of an abscess. (((hugs))) I to was scared of remicade, but it was the only mediciation to help my periannal crohn's, and I've tried them all. Don't be to quick to rule it out, as it may be your answer.

Julia

Hello Everyone, I would like to thank all of you for responding to my post. I do believe this anxiety is my biggest problem right now. I am seeing someone for it and have been for years. I was doing so good for years but because of all the worry about crohn's disease and now this abscess and fistula I am having such bad anxiety that I wake up all through the night having anxiety attacks. I have been on xanax for it for years and have only needed to take 1 mg. in the morning and 1 mg. at night before going to sleep even though I was told I can take it up to 4 times a day if needed. I never wanted to take that much of it because I wanted to eventually be able to stop taking it. Now that I am going through the worry of possibly having surgery to put a drain in and how much pain I might be in I am freaked out and I have had to take the xanax 3-4 times a day (something I said i would never do). The anxiety gets so bad sometimes that the xanax doesn't even work. I have tried to go on youTube and do relaxation exercises. My worry is that i am letting the anxiety compromise my health because i am so scared about everything. I'm scared to be put to sleep and have surgery, Im scared of what pain medication they will give me because i don't want to feel drugged up, I'm scared of all the stronger medications for crohns disease, I'm scared of dieing from crohn's disease or any infection that i might get from the medications. I have so many thoughts racing through my head and they never stop. One thing i can say though is i am so glad i found this forum. I think it might help me to know that I am not alone with my fears and be able to hear other people who have tried different medications and are feeling better and enjoying their life again. I have been on other sites and it made me so depressed because everyone seemed to be not doing well and only mentioned the bad things.

I want to be able to enjoy my life again with my kids and my husband. I need to know that this is something that can and will happen. I have found myself crying while i am in my room with the door closed and I can hear my husband and kids laughing and playing. I feel bad that my 3 and 4 year old are so young but know mommy doesn't feel well. They come in my room and ask me "mommy, do you feel better". My older children are very worried about me. I have lost so much weight that their friends are asking them if i am sick. I don't have any family except for my kids and my husband and i want to be here for them.

I remember asking the doctor if i could die from crohn's and he paused and said well it's defiantly something you don't want because there is no cure. This is the new doctor I just saw at Mt. Sinai. I think that only made the anxiety and panic worse because he didn't say i wouldn't die from this disease. I wasn't having diareah before that (just soft bowel as usual) and now I am running to the bathroom with diareah (sorry for to much information). I would really love to find a good GI doctor in Long Island because I would feel more comfortable then going to the city. If anyone knows a good one that will take healthfirst and they are in Nassau county i would really appreciate it if you could let me know. I also need to find a colo-rectal surgeon because I don't feel comfortable to go back to the one who put the incision in to drain the abscess. I need to do something really soon because this abscess/fistula or fitula's are just draining and draining and the incision site is starting to get sore. I'm so sorry this is so long and i am rambling on. Thank everyone again for your responses and if there are more people out there that can tell me about what to expect with the surgery and seton drain I would really appreciate it so much. I think I need to work on that first and then figure out what to do as far as medication. I need to take one thing at a time because right now I am so overwhelmed. Sorry if there are any typo's.

Well, I put a post up regarding the Entocort EC and was scared out of my head when someone told me I could go into a adrenal crisis. I don't understand because when I called the pharmisit like someone suggested he told me if it wasn't working for the crohn's then it is ok to just stop taking it. He said they tell you to taper off when it is working because Entocort EC is really not something that was made to use for more then 3 months and is suppose to be temproary. Anyway, I started taking it again this morning because of the fear of adreal crisis. I will taper it down each week.

I am very worried about the abscess. It doesn't hurt if I am sitting down or laying down but when I stand I feel pressure. I can feel it on the right side where the incision was made and then I feel another hard lump under my tail bone and then on my left side I feel another hard lump. I am not sure if it's all one big abscess or different one's. Has anyone ever experienced this? I really don't think I can go into the city again even though I heard Mt. Sinai is a very good hospital. I really need to find a good GI doctor and Colo-rectal surgeon in Long Island (nassau county) or Queens. If anyone knows of a doctor PLEASE let me know. The insurance I have is healthfirst which does make it hard to find a really good doctor who cares.

I remember reading a post about someone's abscess got so big that they could have become paralyzed if they didn't make it to the doctor in time. I am so scared because I can feel the one I have is under my tail bone and I don't know how big it is inside my body. I hope someone can help me with some advice or put my mind at ease so I can stop freaking out about everything.