Abscesses-Crohns or UC or ?

This is my very first post. I have been reading these forums for two months now. I'll start from the beginning. Three months ago I felt like I had a pulled muscle due to moving from a house and apartment and into a condo with my boyfriend. The pain was in my butt area so I thought I had pulled a butt muscle. about a month after the pain started I started having a pus like discharge from my anus along with fever and chills. My boyfriend and i told some doctor friends of ours and they told us to go to the ER because it sounded more like an abscess than a pulled muscle. Turned out it was about a 2.5 cm abscess after they did a CT scan in the ER. They sent me home with antibiotics and pain pills. Two days later I was in so much pain that we went to see the Doctor referred to me the night at the ER and after an ultrasound I was sent to emergency surgery to remove the abscess. It was internal so they did surgery under GA and drained it internally and kept me two nights because they feared I was septic and wanted me on IV antibiotics (cipro and flagyl). My surgeon said he thought everything was drained but after a week it felt like it was coming back so I was referred to a different surgeon (a colon-rectal specialist) because my surgeon knew he wasn't capable enough if it had indeed come back because of its proximity to muscles etc. I saw the specialist and it had indeed come back (or was never really drained) and had surgery again, three weeks later. This time they felt sure they drained it completely and had found the source (a golf ball size abscess). It was intersphencteric (spelling?). So we thought we were on the right track and I'd start feeling better. Three weeks later, it was back and bigger (I could tell from the pain, fever, and the lump I could feel under my left butt cheek). So they did surgery again, internally, under GA yet again. This time they put in a mushroom catheter in hopes that it would keep draining. I had the catheter in for a week. They took it out because it wasn't really draining much and it really hurt. Three weeks later (just last Thursday) I was back at the doctors again because it was back, I could feel it, had the fever, etc. This time they decided to go at the abscess externally and cut me open because they thought it had migrated from between the two sphincter muscles to the fatty part of my butt. They put me under GA again and found a pretty large mass but when they tried to drain the mass nothing came out and they were too concerned to try anything more aggressive so it was deemed an unsuccessful surgery. So now, here I am, with a gaping hole that my bf has two pack twice a day, that is draining from the wound and my anus and we still don't have any answers. What caused the abscess in the first place? I've always been a constipated person and if not constipated then i have D. I've had anal leakage and some drainage on and off for a year or so but I've never had any testing done. I asked if I might have Crohns or UC, just because I seem to have some if not all of the symptoms described but the only answer I've gotten as to what caused the abscess is bad luck. And that they want to do a colonoscopy but have to wait until I heal. I've had 4 surgeries in 2 months and it looks like I will be having a 5th eventually and nothing has taken care of this abscess. I am due to have an MRI this coming Thursday 6/18 to see where the draining is coming from. I just feel like they have been treating the acute symptom for 2 months (unsuccessfully I might add) but they aren't trying to figure out why. They haven't put me back on antibiotics because they weren't working and don't want me on them for an extended amount of time. Can anyone help? Shed some light? Does it sound like crohns? UC? IBS?

Thank you for the response. I realize it was a behemoth of a post. It just has me worried. I'm a fairly healthy person, besides the constipation/diarrhea problems and had only ever had one surgery, a tonsillectomy back in 2001 when I was 19. And now I've had four since April 9th. The abscess(es) are very painful and after each surgery I miss at least a day or two from work and then I have to go back because I've used up all of PTO. So I want to get to the bottom of this and start treating the cause. I'm not hoping it is Crohn's by any means, because from what I've read it's not something I'd like to sign up for but at least then I'd know and like you said I could start care and/or medicines. The MRI I'm having Thursday is to find out where it's draining from. I suppose I could specifically ask them to target the small colon? I've just found a Doctor where I live who will be my primary care doctor (after all of this started because like I said I'm pretty healthy so I never had one). He saw me only for a short visit because he sent me straight back to my surgeon because he felt my lump, so I was sent off to have my 3rd surgery. He wants to set me up with a gastroenterologist for the colonoscopy. I guess I thought that the surgeon I'm seeing now would qualify as a specialist because he is the head of the department at the teaching hospital I'm going to. He's the second surgeon I've had and like I said he's he second one to tell me abscess is just bad luck. The only reason I came up with Crohn's was because in a search after my ER visit with no surgery I looked up perianal/perirectal abscesses and Crohn's and UC were the number one underlying causes that could have pertained to my situation at all.

The first three surgeries took it out of me because of the anesthesia I think and because of the poking and prodding of the surgery itself. This 4th one I just had has left me drained because of the anesthesia, poking and prodding (when the Dr found the mass he also went in internally while also being external), and the cutting itself. The packing that my bf does everyday is agonizing and he hates the fact that he's causing me so much pain. I work full time and I'm a full time student in an MBA program and this whole experience has just left me drained. I'm thankful I found this website (even if it turns out I don't have Crohn's) because I've been able to read about others who have had similar problems. Though it seems that most of the posts I've read regarding abscess(es) and their draining have been the external kind and not internal like my first 3.

Thanks again for your reply and I apologize once again for my rambling. The pain and pain meds they have me on keep me up most of the night.

The MRI should tell you a lot. I don't think you need to ask them to target a specific area; if they can't find the source, they should realize that and do a more extensive MRI. But the MRI they order will likely cover enough area. Let us know what it shows. Ask the doctors for a copy of your results (the radiologist report), which should be available in 24-48 hours after the procedure.

I have had digestive issues since I was a baby (of the constipation kind). When I was older and in my first year of college they decided I was gluten intolerant and had me try and alter my diet to potato bread, less wheats, etc. I however didn't follow it because I was young and I just dealt with my constant stomach and digestive problems. These abscesses have just crept up on me and I tried to bring up Crohn's or UC when the first abscess happened two months ago but the doctors seemed to blow it off. I'm not sure if I have Crohn's or not. Or if I am just unlucky enough to have had 4 surgeries in the last 2 months. I know I didn't want to have them but it seemed like there was no other alternative due to the pain and discomfort I have been in since the beginning of April. My abscesses were/are internal. I didn't have anything poking out of my skin or oozing from the skin like a zit would. My discharge was coming from my anus so you bet your butt I was scared and wanted to fix whatever was going on. Unfortunately for me, nothing has been fixed yet. Hopefully the MRI will show something tomorrow and if not, hopefully I will meet with a gastroenterologist who can help me figure out what is going on. I don't have a fistula yet but I was told that this might be an outcome of the most recent surgery I had this past Friday. I don't have any children but hope to someday and no one has said anything to me regarding not having vaginal births in the future (we haven't even discussed what my underlying problem is).

Before I was diagnosed with Crohn's I also developed an abscess. I was already having symptoms of Crohn's, just couldn't find a doctor that took me serious.

I had a golf ball size lump next to my rectum. It was very painful, so my heart goes out to you there! I had a doctor tell me it was an abscess and just sent me home with antibiotics, which did nothing. I suffered for a week and it finally drained on it's own in the bathtub. Unfortunately it was also a fistula, a tunnel that went from my rectum to higher up in the anal canal. I also ended up having surgery, but what they did was open up the whole tunnel tract so it could heal from the inside out. Sounds like yours is too internal for that. Wasn't a fun surgery and took a whole year for it to heal. Mind you I still didn't get diagnosed with Crohn's for several years after this (they went with the oh your just unlucky route).

You definitely need more tests to see what else could be going on. A colonoscopy is the best route as soon as your able to. Like others said IBS would not cause that.

So I had my MRI yesterday and my follow up with the surgeon after my external/internal surgery for my recurring abscess that started between the two sphincter muscles and then moved outwards (this is why they say they did three internal drainages/surgeries and why the last or 4th one was a little bit of both. The MRI didn't show anymore abscess or areas of concern. It did show the abscess itself and the pretty large area that has fluid/infection/pus in it. It also showed how a fistula or tract is forming?. I will continue to have my bf pack the wound for the next week or at least until he can't pack it anymore. It is one of the worst pains I have experienced. I guess if it doesn't fully heal I will have to decide what to do if I am in fact left with a fistula.

I asked the surgeon once again if he thinks it's just my bad luck that I had a cavity or anal gland that decided to become an abscess and lead to four surgeries, multiple weeks on antibiotics, four GA's, etc., and he said yes. I brought up Crohn's and he said there is no reason to worry about that at this point, especially because I don't have any other symptoms that would point towards Crohn's. The only symptom I don't have in my opinion is diarrhea. He said that he would pull my CT scans and my MRI that I just had up and we could look at the colon and surrounding areas but then we ran out of time.

I'm to see him every week for the next month or so (the hospital we have to go to in order to see him is an hour away). And he said down the road, when I'm healed from all the surgeries we could look into getting a colonoscopy.

I guess on the outside to everyone looking at me I'm just some crazy woman trying to diagnose herself by what she reads online. This might be true. But every time someone hears what I've been going through they ask if I have Crohn's or if I've been tested for Crohn's yet, etc. etc. I'm also trying to come up with or at the very least have someone in the medical field come up with or tell me why this happened in the first place (bad luck just doesn't sit well for me). I'm grateful that they are trying to take care of the abscess and the symptoms that are happening now but I'd like some answers as well. Am I just crazy for trying to diagnose myself with something I don't have?

Hopefully soon I'll be able to go back to my primary care doctor and we can continue going over my history and maybe get some tests done and get me sent to a gastroenterologist.

char2482, keep pushing for answers. You're not crazy at all to fight for answers and fight for yourself. Lots of us had to push for YEARS before getting a diagnosis.

Your surgeon says you don't have any other symptoms that point to Crohn's? So what! You don't have to have any other symptoms. What you have might be enough on its own. Some people only have disease in the perianal region and nowhere else.

Next time you see the surgeon (next week), ask for a thorough review of the MRI and CT scans that you were set to talk about this time.

Then go from there with the colonoscopy and other tests as needed.

I will keep pushing for a more definitive answer than "bad luck" as to why I developed a recurring abscess, that isn't going away even after 4 surgeries and three weeks of antibiotics. As for my symptoms from what I've heard this recurring abscess is one of them. Ive always had a difficult digestive system. Mostly constipated but if I'm not constipated I have diarrhea. I'll go 6 or 7 days without going then I'll take something and have D for days. I've had bloody BM since I was 8 or so but I always attributed that with constipation and straining. My stomach is always tender and has a bloated feeling. There are bouts when I'll wake up every morning with a horrible stomach ache, like I'm starving (that kind of burning sensation in my gut). Not sure how to describe it. After some meals, every once in awhile, I'll barely make it home before I throw up and then I'm cramping all night until the pain subsides. For the last three years or so I've had a leakage from my anus but always ignored it and even a couple of times I've noticed a discharge/mucous when I wipe or in my undies (all of this was pre abscess so two months ago). The pain I felt along with a lot of discharge is what finally led me to the ER where I found out about the abscess.

He's the head of the colon/rectal Surgery department. He's a wonderful surgeon but I think you're right and it's just not his specialty. Surgery is.