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Abscess advice needed -newbie

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Crohn's Disease
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Posted 6/21/2015 4:21 PM (GMT 0)
Hi everyone,

I usually post over in the UC forum but have found that you folks have more experience with what I'm dealing with.

Last weekend I awoke with a painful feeling in my rectum that progressively got worse until I could barely do anything except lay in bed. I thought it was a nasty rectal UC flare but it felt different than my first flare. After a trip to my GI Monday, she sent me directly to the local GI surgeon who confirmed her diagnosis of an abscess (not sure exactly what type of abscess). It protruded from just inside the anus and up the crack of my butt. He lanced it under local anesthesia and I was there a total of 15 minutes (holy @@@@ that hurt!) but I felt relief within a couple of hours.

I have a few questions:
1. Should I expect this to be a recurring problem?
2. Is it usually lanced under local anesthetic? I got in right at closing time and felt they really rushed me in and out.
3. If it turns out to be a fistula, should I research to find a respected surgeon to deal with it? I know there are a couple of options for treatment and I want someone who can get it right the first time.
4. Though I've gotten a diagnosis of ulcerative colitis, the surgeon mentioned that the presence of an abscess may be an indication of crohn's disease, not ulcerative colitis...though this is not necessarily the case. He said I just need to keep that in the back of my head. Any of you begin with a diagnosis of colitis that later changed to crohns?
Posted 6/21/2015 7:20 PM (GMT 0)
My original diagnosis was UC, then I got an abscess that turned into a fistula. It's fairly common.

It may or may not be a recurring problem. Are you packing it?

My first one was rushed like that, just in the ER. They didn't give me anything for packing and that's how it turned into the fistula. The second one about two years later was done under general anesthesia with a surgeon (not the ER dr), was packed, and I was admitted for a few days. I also went septic, but that's due more to the lateness of finding it than how it was handled after discovery.

If it is a fistula, you will want to go with a colo-rectal surgeon. As your GI who they recommend. See if they have good reviews, etc. Do NOT go with a regular surgeon. A regular surgeon once told me that if any other regular surgeon said that it wasn't complicated and I didn't need a specialist, that I should run away screaming and not look back lol.

What meds are you on? Remicade is pretty good at healing abscesses and fistulae.
Posted 6/22/2015 12:59 PM (GMT 0)
I'm only on lialda and bactrim (post surgery), my symptoms haven't been that bad outside this issue
Posted 6/22/2015 1:31 PM (GMT 0)
Ok, I would DEFINITELY talk to your GI about starting Remicade ASAP before you have major surgery.
Posted 6/22/2015 6:11 PM (GMT 0)
My insurance company made me go on lialda for 6 months before they approved me to go on remicade. It gave me my energy back but did nothing for the fistula.
I started remicade in May 2010 and by July my fistula had closed. That's the power of remicade! Unfortunately it reopened in January 2011. The fistula tract never really goes away.
You're probably going to get rediagnosed with severe Crohns disease now.
And good luck finding a good surgeon to cut you. I've seen two colorectal surgeons and both refused to come near my fistula, saying that cuting it out would just create 10 more.
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