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Fistula flare up with seton

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Posted 8/13/2018 12:00 AM (GMT 0)
Hi all,

I recently got a draining seton for a high anal fistula. That was a month ago. Doctor said he would let the seton calm the infection down before he did a follow up operation. Everything was going fine, I still had a bit of drainage and pain post bowel movement but it was manageable. However, 5 days ago I got a horrendous flu. 3 days into the flu my drainage started becoming heavy, including a fair bit of fecal matter and light pus. Now my butt feels a bit cramped and sore inside. I want to stress that my flu was an actual flu, and I’m getting better now. The fistula flare came half way through. Does anyone know if your body is constantly battling a fistula infection when it’s there and then, if you get a bad virus, it no longer has the resources to temper the fistula, hence the big flare up? Or maybe they are related and I need to see someone? I went 8 months without a seton so it would anger me if it’s made things worse, not better. Prior to the seton I was getting almost no drainage offical matter. Almost feels like the seton made the bloody fistula larger!

Hoping that the flare will go down as I recover.
Posted 8/13/2018 9:30 AM (GMT 0)
Hi DBrookenz,
Flare ups are absolutely normal even with a draining seton on.
The draining seton is still doing its job; a) fibrating skin around the fistula thus making the fistula more narrow and clearly defined for future surgeries b) moving the fistula towards the surface functioning as a slow cutting seton and c) draining the infection during flare ups. Don't worry as long as you have a draining seton; CRSs have been working with these for a long time and they can do miracles with them. Just follow their directions and eventually it will work out.
Posted 8/14/2018 1:15 AM (GMT 0)
Thanks Dimitri. Your own success fills me with hope!

I ended up at the doctors and she said it was a flare up but thankfully drainage was still good, so there was no abscess forming. Gave me Flagyl to try temper the flare up down a bit. Already seems a bit better.

I just want this fistula nightmare to be over.
Posted 8/14/2018 12:43 PM (GMT 0)
Dbrookenz it seems tough now but It will be over for you at some point as well, as with memmem, no fistulas and myself...
Posted 8/14/2018 9:04 PM (GMT 0)
Glad you have no abscess. My suggestion is to get on abx ASAP if you think you have one.

How did she know there was no abscess forming? Did you have a CT scan?

I had multiple with setons and continued needed several I & D's. Setons were pure torture for me and I was in hospital for 6 weeks of hell. I had them removed after 8 weeks. Stelara really has helped over the last year although I may have an abscess now....unsure.

I'm in Canada and they don't do fistula repairs here although I'm seeing a surgeon about a stem cell transplant next month.

Post Edited (U B Tough) : 8/14/2018 3:48:39 PM (GMT-6)

Posted 8/15/2018 12:23 AM (GMT 0)
Hey U B Tough,

That's really rough they don't do fistula repair. I know there's a lot of failure with fistula surgery but equally, if not more so, there's success. it's just a long term journey. Sorry to hear yours has been so horrible. I had a seton when I first got my fistula. It fell out of its own accord a couple of weeks later and those two weeks were hell for me too. However this time around the seton was actually going much better. Still had pain and drainage, but less than pre seton and it had given me hope that things were settling enough for a follow up operation.

I'm on Flagly now, since yesterday morning. Hopefully that will settle this flare up. The GP I saw seemed pretty good on fistula. Most GPs I've seen know about them but not in great details like a CRS but this woman was different. She had a look and a press around and said she felt no fluid build up. She also said she could press on skin and the pus would come out where seton was. In other words, she said the area seemed swollen but drainage was still occurring easily, hence no abscess.

Keep us updated on your own journey my friend.
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