Trying to get into remission with a fistula

In September I had an Perirectal abscess drained and a draining seton put in shortly after. Living with a seton is interesting. Some days I forget that it is there and other days I have tenderness and trouble sitting comfortably. I was told that my fistula is high and complicated. They have not done a dye test to see exactly where it is going and how complex it is. I was told that it would be done when my seton was put in but they did not.

The past few days I have been very uncomfortable. There is a hard long bump under my skin near the opening of my seton. When i pushed it yesterday pus came out and it was noticibly smaller, but today seems longer again. I am so worried about getting another abscess but don't know when I should be going to the doctor. Is the pain I feel from the fistula or from a new track that is forming or is blind? How can you tell if there is infection? I take sits baths several times a day and this brings some relief, but I want to take care of my seton so that it does not get infected.

I am adjusting slowly to life with extra orfices but i never imagined how hard it could be. The surgeon said they will look at it once the seton has been in place for a few months to see what can be done to repair it. I have been researching constantly since September about CD and UC, diet for CD. I feel like the more I know the less hard balls I will have to dodge.

Over the years I have had some scary flares and I have been sick for a long time but never as severe as this. When this roller coaster started in September I never imagined it would be like this.

Yup, yup. I'm w/Jason on this. When there are changes, its time to see the gastro to bring him/her up to snuff and determine whether there needs to be anything different done.

I agree with everyone that any changes should be reported to your doctor – you may have an abscess forming and need to be seen ASAP! Are you on any maintenance meds for your Crohn’s?

Hi all I have been here many times over the past 2years but have never made myself present. My son fell very ill in Late 2010 and I pretty much had him diagnosed by reading your posts. He like yourself had a perirectal abscess. We took him to the local hospital,waited in total about 14 hours over 2 days before they drained it.(very long time to have to sit on an abscess for an 11 year old) He then developed a fistula (which turned out to be 4) he was put on cipro and flagyl, went on prednisone, methotrexate, calcium, vitamin D and folic acid. He struggled with sitz baths 2-3x a day for over a year. I always kept the fistula covered with fresh gauze which apparently kept it very clean and we were able to avoid having a Seton placed. Unfortunately the fistula just were not healing. We had him start Remicade in Feb. 2012, after the 3 induction doses he started going every 8weeks for an infusion. There were no signs of any fistula after his first regular dose in June 2012. It worked really fast. One time his fistula started getting more infected and his GI had him up the dose of either the cipro or the flagyl(sorry I am unsure of which one but your GI would have to recommend it for you) it released the excess infection within 2days. You do not want the infection to stay inside, his started to get a really firm spot and then stopped draining. When it stops coming out and stays in, that is exactly what an abscess is, so defiantly contact your GI.
I do know that to start Remicade you can not have any infection going on in your body and that is why they place a Seton in, so that the infection will continually drain. If you are worried about the cost of Remicade you are right it is very expensive, it is different for each weight category. Initially we were at 2200$ now we are at 3300$ every 8weeks. Fortunately I also live in the area and know that there is a provincial plan that will assist you. So when it comes time make sure to look into it and don't let the cost hold you back. Yes it is a very scary drug and I was very hesitant to put my child on it but it was a decision I had to make and so far I am very thankful that I did.
It's been a long road but we made, and you will too.

Could you call your surgeon who did the Seton placement for assistance? Are you running a fever? When I had my Setons in place my CR Surgeon instructed me to call him if my fever hit 100 and stayed there or went higher...that usually meant I had infections/abscesses working away in there and they needed attention:-(

If you just started Imuran it will take a little while to feel the full effect. The Cipro and Flagyl will help in the short term.

I hope you get some relief soon!