Perianal abscess and now a fistula?!

Hi everyone,

I had a perianal abscess come up in June of 2011 and had it drained under GA in June 2011. Gosh it was horrible.

So the past few months have been up and down - I thought my abscess was well and truly on its way to being healed! I was wrong.

Had my drainage and EUA mid June. Felt fantastic afterwards - was such a relief to have the pressure gone!! And I did sitz baths 3 times a day for about 5 days. I was back at work and up and at 'em about 3-4 days post op. Brilliant. The incision site had healed over nicely and there was no pain, no dramas.....So then in July, about 6 weeks post op, I noticed a tingling feeling around my healed up wound. Within a few days it worsened, and ballooned up to a smaller, but still not nice, abscess. I was MAD! I had suffered so much anxiety over the first one, and it was back again?!

Rang my colorectal surgeon straight away. Couldnt get in to see him for a few days. By the time I did see him, the abscess had burst on its own and everything appeared to be going ok. Surgeon advised me that this sometimes happened, and he examined me in his room and felt around for an obvious tract / fistula, but couldnt see anything and told me as long as im feeling good and it doesnt flare up again, all is good.

So off I went, thinking "yay, all sorted!"

...Nope. It started to abscess again last week, late August...so I rang my colorectal surgeon and he saw me first thing the next day. He ummed and aaahed about it and said he wasnt sure what was going on but it appears i have a fisutla?!?!! I am going overseas to Thailand on a holiday on 9 sept so told him i must get this sorted now. He booked me in for surgery this coming thursday.

Annnway...the abscess burst again on it's own on Sunday - the incision scar puffed up and looked almost blister-like - i was mortified! More blood than puss, but has been leaking/draining over past 24 hrs. I am seeing surgeon tomorrow and then being operated on this Thursday - possible fistula.

Does this sound like a fistula?? What is going on?!!?

Also, surgeon and I have had the crohns discussion and he assures me this is not crohns related. My abscess actually came from an anal fissure - have had problems with them on and off for past 24 months.

Sigh...

I am looking at relocating so i can be closer to my bf and have been for a brilliant job interview and if i get it, I will be required to work long hours and travel domestic and international regularly - and i keep thinking, I am a young, 25 year old, fit and healthy girl - why is this happening to me?!?!

Is there hope that I am going to be able to lead a normal life?!!!! Please tell me there is :S

If you do indeed have a fistula be assured that it isn't the end of the world! :)

I basically had the same thing happen that you did, and it ended as a fistula. My surgeon put a seton in it, and no more abscesses for me!!! I am able to do anything with my seton in. I travel, swim and so on with no problems.

If you do end up with a seton, get some 4x4 gauze sponges. I get mine from a medical supply store. I take two of them and fold them in half and put it right up against the seton in my butt crack to catch the drainage. It stays in place fine, and I change it whenever I use the bathroom.

I hope you can get some answers soon! Keep us posted!

Thanks for your replies everyone. So there is hope! I'm so happy to hear that.

I too know what is it like living with fissures, my surgeon believes the fissures are the root cause of my abscess and now possible fistula.

I am feeling really good today, the area is still quite tender and is basically a small hole, but am seeing my surgeon in a few hours to discuss surgery on Thursday.

Will keep everyone posted as to the outcome! Fingers crossed everything gets sorted! :)

eebs...just wanted to say that I had my fistula treated via seton. Yes, there is life after fistula! Until recently, I worked in a job where I traveled often. I work 40+ hours a week. It can be done. Just be sure to get treatment as needed and take care of yourself.

Hi eebs...I feel like we live in a parallel universe. I am also a very healthy 25 year old and had my first abscess drained in April 2011. I too had my ups and downs and thought I was completely healed.

Then two weeks ago, on Aug 20th I started feeling some pain. The same area was raised like a water blister, so I took a sterilized needle and popped it...and out came droplets of blood and pus. A week went by and the wound healed over yet again.

This past Sunday, Aug 28th, the same darn area got itchy and hot. After running 10 miles, the thing popped on its own. I went to urgent care on Monday morning and they cleaned it out, packed it, and put me on antibiotics.

Today I saw my colon specialist, she felt and looked around, and could not see a fistula. She went through her speech about best case scenario, she would cut the fistula and lay it open to heal...how is that the best case scenario?! She also said if the area is too muscular, she would have to default to the plugs....Then she dropped the bomb about the possibility of Chron's disease.

I don't know how to deal with all of this. I'm so scared for my future...pain is not my friend.

Please pass along your positivity :( and let us know how your 2nd op went.

A little late to the party, but I just wanted to suggest taking sitz baths in an effort to keep your abscess from healing over too quickly.  The first time my abscess was drained (by surgeon), I was not given this advice, and it healed too quickly, leading to another bout of pain and swelling.  This time it popped by itself, and I religiously took sitz baths (as hot as I could handle, for about 15 min.), and the thing is still draining 3 months later.  I sometimes throw in a small handful of epsom salts.

I still don't understand the ins-and-outs of abscess and fistulas, and whether drainage this long is good or bad for either an abscess or fistula, but I've had no pain whatsoever, and all swelling is down.  I have to think that's a good thing.  To manage the drainage, I'm able to place a cotton round (those make-up removal pads)  over the tiny hole, which in my case, is just outside the vaginal opening, near the perineum.  They work great, I change it whenever I go to the BR.

I'm sorry you're going through this - I have the same thoughts so often:  "Why me?!?!?"  If it weren't for this ding-dang thing, I'd be doing quite great.  Hope you find a workable solution soon.

Yes, by all means get one of those portable sitz bath thingies that you can just set on the toilet and soak your bum in.  This is the one I have, but there are lots out there, and they're inexpensive:  http://www.google.com/products/catalog?q=sitz+baths&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&tbm=shop&cid=12166854427137626557&sa=X&ei=XNB5Tv-lCoTW0QGP18zPAg&ved=0CD8Q8gIwAw. 

Although my fistula showed up on MRI, my GI couldn't find the fistula track either.  I'm going back to Cleveland in a couple weeks, and we're going to try again - another MRI with contrast, and a scope.  Not knowing exactly what is going on with the fistula/abscess has been unnerving.

Here's hoping you heal properly!