Help on a Perianal Abcess

My attention was bought to this forum by the number of people posting on here who have Crohns disease and as a result are more likely to suffer from Perianal abcesses.

I don't have Chrons disease, but was hoping that the people on this forum might have some advice for me. I got a Perianal abcess almost 8 weeks ago, it was 4cm wide and 2cm deep, I put off seeing the doctor initially which let it grow so big, but when it got that big I went to the doctor and he told me to get it drained, which I did, the original incision to drain it healed quite quickly but another little pimple/spot appear on the same area a week later, I have been on some antibiotics for 6 weeks now and they have stopped it from growing any larger but its still there, about 0.5cm wide but doesn't feel deep at all, its just on the surface and gets sore which makes it hard to sit down. 400mg of Ibruprofen in the morning and afternoon allows me to sit down without feeling sore and inflamed.

The nurse said I might have to get it drained again :( but there is hardly anything there but it just won't go away. The other option is put iodine or magnesium sulphate on it to draw out the pus and force the skin to close which might mean it will still grow under the skin. Has anyone had anything similar? Or know of any other options?

Sorry for all the spelling errors....iPad keyboard!!!!

Hey David.
If the abscess is small I would not be to concerned about loosing to much time at work. I would try to have the procedure done on a Friday afternoon if you work mon-fri allowing the weekend for recovery. I had a small abscess drained about 10 years ago and I was back at work the next day. It was still a bit sore and I wore a small gauze but I was able to function just fine.
If its determined that you have a fistula and they are going to operate on that, I would give yourself at least a week or two off after. It was quite painful in the days following. Having said that they will prescribe you pain meds which work well. I just decided not to take them because they made me queasy. Fistula is a essentially like a tube, what they do is cut all along it so it lays flat, it then heals itself outward so it doesn't close up and form another pocket. That's how the doc explained it to me in terms I could understand.

My earlier suggestion about the sitz baths and cream is just a short term solution to ease the discomfort, I would highly recommend seeing a medical professional. Its my understanding they don't heal themselves to often.

Good luck, don't let this thing get you down as tough as it is.
Don't hesitate to ask if you have any more questions
Al

Ajo82 said...
Hey David.
If the abscess is small I would not be to concerned about loosing to much time at work. I would try to have the procedure done on a Friday afternoon if you work mon-fri allowing the weekend for recovery. I had a small abscess drained about 10 years ago and I was back at work the next day. It was still a bit sore and I wore a small gauze but I was able to function just fine.
If its determined that you have a fistula and they are going to operate on that, I would give yourself at least a week or two off after. It was quite painful in the days following. Having said that they will prescribe you pain meds which work well. I just decided not to take them because they made me queasy. Fistula is a essentially like a tube, what they do is cut all along it so it lays flat, it then heals itself outward so it doesn't close up and form another pocket. That's how the doc explained it to me in terms I could understand.

My earlier suggestion about the sitz baths and cream is just a short term solution to ease the discomfort, I would highly recommend seeing a medical professional. Its my understanding they don't heal themselves to often.

Good luck, don't let this thing get you down as tough as it is.
Don't hesitate to ask if you have any more questions
Al

UPDATE: 31st August 2012

Ajo82, you were right - it ended up turning into a Fistula. So here is my update around 6 months later from getting that Perianal Abscess.

After a chat with a surgeon/consultant last month, he probed my "hole" and said the abscess which had been drained, had created "abnormal passages" underneath the skin mass which happens to about 20% of people who have an abscess drainage, as the body tries to create a path of least resistance for the infection/pus to come out, it created 2/3 of these passages which meant the abscess never went away. I had an MRI scan done to confirm this and then had the operation as little as a week ago, known as a fistulotomy, where they basically lay open the fistula and its opening tracts. I had this done under general anesthetic, which only took about 20 minutes, I was a bit uncomfortable for 3-4 days after, they gave me Paracetamol and Codeine and told me to take Ibuprofen afterwards. But almost a week later I can sit down comfortably, and I am back to Ibuprofen twice a day. I was told to get it cleaned and packed by a local nurse, but the consultant said I only need to get it done every few days - unlike my abcess drained which was packed daily. I am suffering from slight incontinence but the consultant said this was temporary as the muscle heals.

Will try to update my progress here and like you all said never let the abscess or fistula get you down! Thanks for all the help.

I'm glad to hear that you're doing well! Abscesses and fistulas can be extremely frustrating, whether or not you have CD. Hope it keeps healing well! Keep us posted!