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How do you deal with both the pain and draining of a perianal fistula?

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Crohn's Disease
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Posted 1/30/2016 12:56 AM (GMT 0)
I can't figure out what causes the fistula to start oozing. The pain these days is unbearable and I keep having rectal discharge. My GI suggested 2 weeks ago I start a round of both Flagyl and Cipro but I refused. Flagyl causes me non-stop vomiting and Cipro led to blood in my esophagus 3 years ago. Would an antibiotic help with the pain? What do you do to deal with the draining? I have soiling most of the time, too. They are really annoying.
Posted 1/30/2016 5:51 PM (GMT 0)
Well I have UC and have gotten rectal abscess from time to time, some have fistulas,now dormant.
Anyhow hot sitz baths will help a lot with the pain and infection, also antibiotic cream.
Old Mike
Posted 1/30/2016 6:44 PM (GMT 0)
Is it a burning pain from the drainage on your inner buttocks? If so The only thing that helps me is using the shower head on cool and cleaning the area several times a day. Then making sure it's really dry. Or like Mike said, sitz baths. Drinks lots of water too. Some people place a gauze pad in btw the cheeks but I could never tolerate that very well. You have to be careful about putting creams down there cause the fistula can get infected of some gets in there.
That's what my colorectal dr told me at least.


Im allergic to Cipro and Flagyl is a nightmare for me too, plus last time I took it I developed cdiff! Unfortunately that's the only thing the docs say work. I kind of find that hard to believe, but they haven't offered up anything else. Hope you feel better soon. I feel your pain :(
Posted 2/1/2016 12:59 AM (GMT 0)
I understand how you feel – I had many fistulas and abscesses over the years.
Fistula oozing means you have active inflammation. Antibiotics are needed to prevent infection from spreading all over you body. You need to take something to prevent this! Sits baths or a long soak in the tub is the key to keep discomfort to manageable level for me. I do few soaks per day. I also wear a pad to soak up draining. Have you talked to your GI about draining seton – that helps with draining and build up in the fistula. Also, I take pain meds when I needed it – that’s what they are made for, specialy to sleep at night. Unfortunately, there are no magic fix’s or tricks here- no secrets that one specialist someplace knows of, fistula is complicated issue and part of this dreadful disease…
I have gotten married, had kids, worked for many years and traveled the world with Crohn’s – you can have a life with it!
The goal is to treat the infection first and decrease active inflammation with whatever works for you – Humira kept me symptoms free for 3 years! I keep having fistulas, but I learned my new “normal”.
Also – new meds are being developed all the time, many meds trial going on all the time – don’t loose hope.
All the best!
Posted 2/1/2016 4:02 PM (GMT 0)
Dear all, thank you. I appreciate all your pieces of advice. Well, I'm trying to learn how to deal with this new problem. My GI told me to use anusol to soothe the pain but Rose*flo mentioned her colorectal surgeon warned her not to do so. All I'll do is to try to cope. I learnt to cope with this d disease 9 years ago before it has been confirmed.
All of you take care :)
Posted 2/1/2016 5:24 PM (GMT 0)
Minnie - you might want to try the anusol...my colorectal surgeon gave me some antibiotic gel with pain relief when I had my fistula so I guess opinions differ. I had neuro effects from the flagyl and am not allowed to take it, but fortunately the cipro worked well. I just need that in a lower does though because higher made me sick.

Sitz bath whenever you can, warm shower rinsing and gentle drying---if you have a cold setting on your hair dryer, I used that from a distance to dry off without rubbing. I did try gauze for absorption and it was difficult until I combined a gauze used for 2nd degree burns to my arms a long time ago--had a shiny coating that did not stick to me at all in combination with ultra thin feminine pads situated near the back of my panties...it seemed to catch it all without keeping the irritation too close to my skin---once again though lots of sitz bathes and changing gauze often help.

If you can take some sort of antibiotic, it will help the ooze. Take Care
Posted 2/2/2016 4:41 AM (GMT 0)
Hey old mike, what kind of antibiotic cream do you use?

For relief of drainage on skin my wound care recommends liquid bandage. I also read about something, I think it was calamine on Amazon for this also
Posted 2/2/2016 4:45 AM (GMT 0)
Minnie, not sure but maybe ask a naturpath about a natural antibiotic... Maybe oil of oregano or berberine. I find it lot important to take probiotics on the same day with these (I take probiotics at night). Usually one hour before or two hrs after an a/b.

But I also was recommended by wound care dr to add hydrogen peroxide to water during sitz baths for a bit to see if it reduces drainage/ infection. He said to use 1:4 ratio of hydrogen peroxide to water. Perhaps ask your dr. Depends if your drainage is infected
Posted 2/2/2016 2:11 PM (GMT 0)
Earthshine: Just regular old generic, triple antibiotic cream.
Sometime I buy the name brand, I guess it is called Neyosporin, triple antibiotic cream, it has
a different carrier than the generic drugstore brands, whether CVS or Walgreens.

Sometime if I get lucky, antibiotic cream will kill the abscess, before it gets real bad.

Another trick is to take DDS-1 probiotic every once in awhile, it seems to make them less frequent,
and or less bad. May also help even after you get one.
DDS-1 is now called UP4, get the one in the yellow box.
If you have a colon they stay in your gut for about 8 days max.
Got my first one in 1972 so been dealing with these for some time.
Of course mine are not crohn's related so, your results may vary.

Old Mike
Posted 2/2/2016 10:18 PM (GMT 0)
Dear all, thank you. I don't know whether my intestines decided all of a sudden not to work or it's one of the side effects of Remicade. After having 10 bms in the weekend, I'm constipated. My GI put me on trimbutine maleat to avoid getting either diarrhea or constipation and rifaximin. So, I doubt I would be able to take any antibiotics.
Will definitely increase the sitz-baths and give anusol a try.
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