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Fistula or abscess?

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Crohn's Disease
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Posted 7/18/2008 7:08 PM (GMT 0)
Hi everyone,

I had an abscess drained at the end of May and now there is still a hole but no/very, very little drainage. How do I know if the abscess is healing or if this is a fistula? I had a follow up with the c/r surgeon yesterday and he made it sound like a fistula, even though the nurse seemed to think it is the abscess healing. Either way, they are not going to do anything else to it unless it becomes bothersome. Any input would be greatly appreciated!!

Thank you in advance! confused

Posted 7/18/2008 8:42 PM (GMT 0)
I had a fistula come thru my stomach, my gi has me on Remicade to heal it. I did a round of Flagyl too. He says Remicade is the only thing that will heal a fistula. Susie
Posted 7/18/2008 11:24 PM (GMT 0)
Hi I had a large abdomen abcess too and as it would not heal it was a fistula .It was several months before it healed and Remicade closed it on the third or fourth Infusion. I was also taking B-12 and Imuran at the time. As soon as I started the B-12 I noticed a difference. Let us know how it is doing. lol gail
Posted 7/19/2008 12:45 AM (GMT 0)
It cetainly could be a fistula. Please be aware that fistulas can partially close which can result in abscessess. I know this way too well -- with and without setons. If you have a peri-rectal fistula, a seton can keep the fistula open so there is less chance of abscessing. I wouldn't hesitate to run to your colo-rectal surgeon if you suspect you are getting an abscess.
Posted 7/21/2008 12:38 PM (GMT 0)
Hello Chas036.

I am very happy to hear your wife is doing so well! Please be aware that CD is a chronic disease that can go in cycles. I don't think we know why the body goes through periodic disease activity cycles. You can read many posts on this forum from folks reporting long periods of remission followed by intense activity. The main point of drug therapy is to keep you in remission and slow down or even prevent further damage.

I have had 3 abscesses and have 2 setons and surely don't want more. When I get to remission I will choose to stay on the drugs because the last thing I want is to abscess again! I think what is contributing to my problem is that the first abscess wasn't taken care of properly by my first Doc and the whole area is really damaged. I wonder if it will ever really heal. More abscesses will just add to the damage. Anyway, I think your wife needs to really consider taking maintenance drugs. Diet alone is not a cure. There have a been a few recent posts where people thought things were fine only to find out after a colonoscopy or other tests that their disease was active and doing damage.

Take care.
Posted 7/21/2008 5:12 PM (GMT 0)
Hi - I too had this problem.  Mine was from my intestines to the outside of my stomach/abdominal wall.  I could tell mine was a fistula because it drained the same thing that went through my intestines (puss, poop, my meds, all that good stuff).  I tried Remiciade (4 doses) and it closed it almost all the way, but not enough and over a month or so it would open again.  It even closed a couple times fast and it got infected and the doc would have to go in a reopen it and make the spot really big to start the healing process over.  The thing is with an fistula it has to close from the bottom (inside) out and this can take awhile.  6MP and time finally closed mine - it took about 9-12 months.

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