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Perianal Abscess Treated with Just Antibiotics?

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Crohn's Disease
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Posted 7/28/2016 10:04 PM (GMT 0)
Did this work for anyone? I have had this abscess that was seeming to come and go, but never really broke open on its own. It has been very painful the last 2 weeks or so and just recently when I looked it's a deep purple color and very angry looking. I am horrible at waiting to call the doctor, I really don't know why. Actually, my GI just happened to call me Tuesday night to check in so I told him about it and he told me he'd call my surgeon the next day. I never heard back Wednesday and by Wednesday night I was near tears from the pain and frustration so my husband called my surgeon this morning (I am a baby, I know. But he has a pretty good relationship with that office from when I was really ill a few years ago).

CR surgeon is off until Saturday (on-call) so another DR in the office wrote me a script for 500mg Flagyl 3x/day and I have an appointment with my surgeon Monday morning. Her nurse said I could call over the weekend if it gets really red and tender (which it has been for like a week now, but whatever) because she is on call. I have only taken 1 Flagyl so far and it may be in my head, but I feel like the pain has lessened some. So what are the odds this will take care of it and I won't need it surgically opened? This dosage of Flagyl is causing major nausea, but I will definitely suck it up if it will do the job.

For those of you who have had abscesses opened surgically, what was that like? Is it a pretty quick procedure? I think my appointment Monday is just so she can check it out. She won't want to open it up right then and there will she? I'm planning on working a little after the appointment. Is there any recovery I need to plan on?

Also, there is a chance that the abscess is already opened slightly and leaking a small amount of puss. Or this could be another fistula I have. It is like a minefield back there I swear. I can't decipher one thing from the other.
Posted 7/28/2016 10:46 PM (GMT 0)
Oral antibiotics have never helped my RV fistulae in the past. I'm glad it's eased a bit, but I am pretty concerned. I had one that burst on the inside and I went septic; it was pretty awful. If it still stays painful, etc. then I would go to the ER.

opening it surgically just depends. My first one they just did a lidocaine shot and cut it in the ER, but then the ER doctor freaked out because it was a lot deeper than he thought (he thought it was just from an ingrown hair or something stupid like that). They packed it but didn't send home any packing with me, and it only healed on the outside and re-formed and burst through into the vagina and that's how I got my recto-vaginal fistula that hasn't healed, and that was over 4 years ago and I'm on Remicade.

The second time, my GI was gone and I didn't have a surgeon yet (I'd only lived in that area for 6 months). The PCP told me it was just a swollen gland because I didn't have a fever (I never get them) and sent me home. It got too painful that night so the next morning, Saturday, I went to the ER. The ER dr called a surgeon and they did it under anesthesia. I was admitted for observation that night, which was good because I got a sudden fever of 104 and it turned out I'd gone septic. It took 5 different IV antibiotics all at the same time for days to get things under control. But they showed me how to pack it and I had my husband pack it every night for about two weeks so that it healed from the inside out. I've never had any trouble with it.

Sepsis is rare, so please don't let me freak you out, but if you get a fever, go to the ER immediately. And make sure that with Flagyl you take a ton of probiotics so you don't get c. diff. I personally like Florastor because you don't have to space it apart from the antibiotics and it's more effective than regular probiotics because it's yeast-based. I take 4 per day while I'm on antibiotics.
Posted 7/29/2016 2:32 AM (GMT 0)
Had an abcess 3 years ago. I had first severe pain. Saw the CR surgeon who diagnosed it as hematoma from an anal fissure. I asked for an antibiotic but he said no need. It happened that I was having an MRI to rule out a perianal fistula and they discovered the abcess. My GI was traveling then so I went back to the surgeon. He put me on an antibiotic and scheduled me for a surgery to lance the abcess. My GI has always warned me against having any surgeries in the anal area. I waited till my GI returned. He called the surgeon and told him that they will only treat me w antibiotics. So, I was put on an antibiotic 500 mg twice per day for 3 weeks. The CR surgeon declared then that the abcess got cleared. However, pain returned a week after. So, my GI put me on antibiotic injections for a week. I had another MRI done and threy mentioned there was no abcess.

It seems that the antibiotics could not drain the abcess as an MRI I had earlier this year revealed I have a perianal fistula. As a result, I was put on remicade.
Posted 7/29/2016 9:31 PM (GMT 0)
Thanks for the input. I have taken the flagyl 3x now and I guess things are about the same. Painful but not completely effecting my day. The flagyl is making me nauseous which is almost worse than the pain. I obviously have to have this taken care of, I can't go around limping and avoiding sitting. Sometimes I just worry that any surgical intervention just causes more problems than it solves. I'll let you know what the surgeon says Monday.
Posted 8/6/2016 7:29 PM (GMT 0)
Cipro flagyl quieted down my first abscess, but did nothing for it when it resurfaced a year later, maybe even made it worse to the point that it burst in my sleep after 4 days of pain.
You just never know.
I hate the stuff because it makes everything taste like poison to the point where I don't want to eat or drink, so gross! Never again!
Posted 8/15/2016 5:49 PM (GMT 0)
Thanks for the replies. I obviously got in to see my surgeon and she in no uncertain terms said it needed a seton to drain. Upon further inspection under anesthesia, she found two fistula and a really bad stricture in my rectum that she opened as well as she could. I also had an abscess that she had to open. So I have 2 setons and a quarter sized open wound at the moment. Pain was pretty severe over the weekend and I was popping lortabs nonstop but I decided to suck it up today and have been doing ok with just Tylenol.

It's frustrating because I just don't know where to go from here. I have tried every biologic and had major abdominal surgery 3 years ago. Drew, I am always willing to try diet changes and have done so in the past. In general I am what most would consider a very healthy eater. We almost never eat out and I cook probably 90% organic and local. I could definitely be better at cutting sugar and wheat products, but still eat mostly organic meats, veggies, fruits, and cheese and yogurts. My mom makes the SCD yogurt and keeps me in supply. Maybe it's time to tighten up again. My appetite is small as it is and I get a lot of pressure from doctors and family to keep my weight up, which can be hard for me. I probably lost almost 5 pounds this weekend just from the surgery, and I have been eating! As you probably have experienced, drastic diet changes get critisized by my doctors, especially if my weight is low to begin with and I can start to feel like I'm being silly. I'll check your website out to see if you have any fresh ideas for me to try. Thanks for the input!
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