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Healing time for small horseshoe fistula

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Crohn's Disease
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Posted 12/7/2007 2:47 PM (GMT 0)
I went through a bad flare last year during my first year of UC. This year has been great as ive been in remission. However, I have this annoying fistula on my anus. Last year when it was doing its thing I thought it was a hemmie. It was the most painful experience of my life. I could barely walk last fall. The pain was absolutely excruciating!!!!!! Came home every evening and laid in the tub then laid in my bed. Time went on and it got much better just some sporadic annoying oozing. I finally got the guts to go to a surgeon and he probed me and decided I have a fistula (OUCH!)   confused Of course he wants me to now test for crohns which I plan to do after the new year. Dont really want to chance messing up anything now that I feel good so we will see down the line. He did prescribe me flagyl /cipro regimen to see if it will close up. This was a few weeks ago and being I have been in remission didnt want to mess things up so I put them aside. Well the lightbulb went off and now I am willing to give it a go so I started the scripts last night and will continue for about a month or so I guess until I run out. Call it the placebo effect but I do feel a little difference down there. My question for those with similiar experiences with antibiotic treatment for fistulas is did it work and if so how long did it take to heal. I know they can reoccur but feel that since I am in remission the likelihood is much less than if I were in a flare so I just want to take care of it if I can and avoid surgery obviously. Please let me know of your experience with healing the fistula if you have or have not. I know there are alternatives to put a seton(sp) in and remicade but know this is the first step to see if it will heal via the antibiotics....Thanks! :-)
Posted 12/9/2007 4:24 PM (GMT 0)
being that you have a fistula I would wonder if you have Crohn's rather than UC since UC only deals with the superficial layers of the intestinal mucosa. Depending on the severity of the fistula etc they may be able to treat it with antibiotics. Mine didnt get helped with that unfortunately, humira has helped it but not to the point where mine healed.

My fistula is enterocutaneous so it is on my stomach right under my belly button. I was placed on TPN to allow my fistula to heal again that didnt work so now I am going through testing since nothing has helped to heal my fistula. I am going for a fistulagram this coming Wednesday so the radiologist will be inserting a scope into the fistula to determine how deep it is in my stomach. I have a coonoscopy set up for Dec 20th and that will determine where exactly the fistula is coming from as well as how much of the intestine is diseased around the fistula. I will be having surgery to fix my fistula sometime in the begining of the year. I had 3 surgeries so far this year for my CD. I was CD free when they reconnected my ostomy etc and within a few months the CD returned on me :( on average most people get 3-5 years of symptom free CD not me though
Posted 12/9/2007 4:41 PM (GMT 0)
i had good luck with Cipro /Flagyl for years. Then they stopped working. I had close to 6 different fistulas at the beginning of the year, with Humira, I am down to one and I think it is closing

Good Luck. You will find what it takes to close them Surgery is a last option
Posted 12/9/2007 4:50 PM (GMT 0)
Hello,

I noticed no one else responded to your post. There aren't many of us who just have rectal CD. That is what I have -- I had an abcess and fistula. You really need to see a doc and get your fistula taken care of. You can get another abcess, and the CD could "working" on other places in the rectum. You don't want to get more of these things!

I am also in the DC area. My docs are at GW and I am very happy with them. Who are your docs? Also, watch out if you are on flagil -- stop it IMMEDIATELY if you get tingling or sensitivity. Nerve damage (peripheral neuropathy) is common with this antibiotic, especially in the feet.

As for me, I started on antibiotics and they helped the abcess/infection, but my docs say they usually can't heal rectal fistulas. Rectal fistulas almost always need surgery or they can continually close up and cause more infections and abcesses. Once I got the seton drain, the wicked infection disappeared almost immediately. No more antibiotics! I am on remicade and the lesion in the rectum has healed very nicely. So my colo-rectal surgeon says I can now deal with the fistula. Mine is too high so it can't just be cut open (I would certainly be incontenent). My choices are to keep the seton in forever (no risks), try the plug and hope it works, or get the advancement flap surgery (70-80% success-rate with CD -- unfortuately, we don't heal as well as non-CD folks). I plan on trying the plug -- even though there is only 40-50% chance of success with CD, there is no cutting and no harm done if it doesn't take. My doocs recomends I try the plug a couple times before considering the other options.

Let me know how it goes with you!
Posted 12/10/2007 7:01 PM (GMT 0)
Thanks all for your feedback! FallColors, I use the doctors offered by my Kaiser plan. Dr. Butterfield is my GI. I was consulting with a general surgeon, but believe a recto surgeon is better. Within 4-5 days the infection seems to be clearing up nicely but it will be interesting to see if it closes all the way. The discharge and infectious smell has gone away so that is a huge relief. Fyi, I know the occurrence of fistula is much higher with Crohns than UC so ill be getting another scope after the new year. The first one last year during first flare was inconclusive as I was too inflamed. I'll try to keep everyone posted how this turns out.

Posted 12/10/2007 7:31 PM (GMT 0)
I had something similar, a very small anal fistula- oh so much fun and very painful and draining a lot. I had to go see a colorectal surgeon but he thought it was superficial enough to clear up on antibiotics. I was put on flagyl and levaquin (similar to cipro) for about a month and the fistula closed up after about 3 weeks. I haven't had any problems with it since then- it's totally gone. Like you, I noticed a difference after just a few days, and I had this strange tingly feeling as it healed up, so it might not be all in your head :-) Good luck!
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