Question about Setons and Fistula surgery

I don’t have Crohn’s   Diease but I stumbled upon this forum and I was hoping that I could get some advice and experiences of other members.   In October of 2009 I was diagnosed with a perirectal  abscess.   The Abscess was Drained and ended up being a 4.5 cm deep wound.  I knew things were not healing properly with the wound site, so I went to a colon rectal surgeon.    She confirmed that the it has turned into an anal fistula, 5 days ago she placed a rubber band type of seton and told me that in 6 to 8 weeks I would have to have the fistula cut open and allowed to heal. 

My question about the seton ; I can feel the knots in my anal canal and its causing a massive amount of pain and it makes me feel like I need to have a bowel movement, is this a normal sensation? I was told to turn/ move it and when I did this I think I turned it to much, because  the knots passed through the initial opening of the fistual.  The pain has somewhat subsided but I can feel it rubbing against the incision hole now. I'm going to call the doctor first thing in the morning, but I didn't know if any of you guys had experienced this and maybe I'm just being overly worried.

My question about the fistula surgery is, how bad is the scar.  I know everyone scars differently etc but I watched a video of the surgery online and it seems like a huge valley is just cut into your cheek, does it actually heal up a bit better than it looks. 

I would love to hear about any of your experiences and ways that I can make recovery of the surgery go as smoothly as possible.  I have a very low threshold for pain so I’m very nervous that this is going to be horrible pain for a very long time. Thanks again for any help or advice.

Hi Seraphina,

I've posted quite a few times about my abscess/fistula surgery. They don't "think" I have Crohns, but they always say they can never be sure, that Crohns can "do whatever it wants."

I had a rubber band seton placed, it looped up just from the inside of my anus about 2 inches up. My CRS did not tighten it for a month or so, just allowed it to drain the abscess. It was sore and uncomfortable for a while but felt so much different to me than the pain of the abscess and fistula that I had had for so long, that it was tolerable for me. My "knots" hung from the bottom of the loop and really didn't bother me if I had the gauze pad placed properly. Are you using gauze? It applied enough pressure that I eventually just couldn't feel it, kind of like how you forget you are wearing ring on your finger.

I also had an incision, to the right of my anus, to allow the abscess to drain and heal from the inside out. It freaked me out in the beginning, when I saw how bit it was- but I hear it wasn't so big compared to other people. My incision was about 2.5-3 cm deep, and I'd say about 3 cm wide, cut to the right of my anus. It has since healed up and you can't even see the incision, it has kind of just become one of those little "wrinkles." I still have some drainage, and have to wear a gauze pad, but the deep abscess is gone.

My CRS said this may be my new normal, I'm not sure yet. I have to go back and see him again in 2 months- he wanted the scar tissue to heal a bit more before he makes a final decision ( I still have a hard bump where the abscess/seton was, which I don't think is normal, but he doesn't seem too concerned). Overall I feel much better and I loved my seton, I felt sad when it fell out. Weird, I know. That little sucker helped me feel better!

I hope you have a positive experience! I can only speak for myself. Good luck! 

I thought I might update this.  I just went to the doctor and she decided that we are going to go ahead with the fistula surgery in 3 weeks.  I'm not getting the plug or the flap type whatever that is.  She told me I can go home that day and the healing would be better etc.  I was quite miffed when i read the pre op instructions with the whole bowel cleaning etc.  I'm like um i'm sure that area is going to really hurt the day of the surgery, she just laughed, I wasn't laughing.  I'm sure i'll look back on all this and laugh.  I am curious for the ones who have had fistula surgery, about foods after the surgery.  The post op instructions say avoid foods that cause loose bowels or gas,  yet  I have to take citrucel which causes pretty much loose bowels and gas for me, so any food suggestions, I don't think I really will be interested in eating.  I was concerned she said she was going to inspect my colon because she suspects I might have crohn's because of my sudden weight loss and problems with diarrhea and having the abscess.

Yea I have been kinda researching about foods and from the list they gave me it seems she wants me to do a low residue diet.  I'm just going to eat light because when I don't feel well I don't want to eat.  I know I have been killing my stomach already with nerves, the thought of the pain and then pain from having a bowel movement.  I think honestly what is the worst part is having to drink the magnesium citrate the day before, I have heard horror stories about what that does to your stomach :(   Which I don't understand why I have to clean everything out for a fistula surgery.  When she told me I had to drink that I told her don't bother checking my colon and she said I was going to have to do it regardless.  I just keep telling myself it will get better :)  and things could be a lot worse