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Fistula surgery.

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Crohn's Disease
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Posted 6/7/2009 12:11 PM (GMT 0)
I have been diagnosed with severe ulcerative proctitis recently, and curently have 2 fistulas and what appears to be another abcess making its bid for freedom. I am scheduled for surgery on the 15th of July to examine them and potentailly lay them open. I'll be honest I am absolutely petrified (regardless of the fact that I am a nurse!) They will be sending specimens to determin if this is Crohns.
If anyone has any ideas about what may expediate my recovery post op, and or prevent anymore of these little 'irritations' developing I would be exceedingly grateful.
Is it possible for crohns to be isolated just to the last 6 inches of the colon? My colonic biopsies did not show any evidence of granulomas, does this mean that regardless of the fistulas it is unlikely that this is crohns?
Posted 6/7/2009 10:05 PM (GMT 0)
I had a peri-anal fistulae about two years ago. It was a few centimeters above my anus. They did the surgery outpatient. I went home that day and was back at work two days later with little to no pain. I also had a fistulae removed when they took four inches of my interstine last year. I don't think that fistulaes are that big of a deal - except while you have them. Mine was leaking and very painful before removal. I know that there are meds that help keep them from coming back, but I am not sure what they are. You might want to ask you doctor about that.
I have never had any granulomas, but they still say I have crohn's. Lucky us, huh? I would just go to my doctor with a list of questions and not leave until I had them all answered. I would definitely review some of the issues and concerns on this website. People here seem to ask good questions and give good feedback. It might help you hone your questions for the next time you see your doctor. Everyone is different. Your doctor might be able to best help you with these questions. And, if you don't like him/her, find another one. This whole crohn's thing is a long journey. You don't want to travel it with someone you don't like. Good luck.
Posted 6/7/2009 10:39 PM (GMT 0)
Only about 50% of patients with Crohn's disease have identifiable granulomae on microscopic examination. Unfortunately, the fistulae and extensive disease in the lowest portion of the colon sounds like Crohn's. There are several members here that have Crohn's disease mainly in the colon, and a few with it in the lower colon and rectum. I have some nice anal skin tags and my GI said NEVER to let anyone remove them because it could start my Crohn's to flare in that location. At this point my CD is in the terminal ileum.
Posted 6/8/2009 1:53 AM (GMT 0)
My crohns is mainly in my colon and rectum.   I have had numerous fistulas.  Remicade closed my first one.  I am still on it...will be 5 yrs this Dec.  I developed another one and I have a seton in it.   My seton will be 3 this Sept.   My surgeon and I decided against surgery on it at this point.   If I have to delay my remicade, I will get a fistula to my bartholin gland...which is where my original fistula was.   I am just really prone to those nasty buggers!  The best thing you can do post op is soak in the hottest water possible as often as possible, but I'm sure with you being a nurse you are aware that this will help with the healing.   If you have an abscess, I wouldn't be waiting until July 15 to get that taken care of...your surgeon can't get you in sooner?

Keep us updated on what happens.   Good luck!

Posted 6/8/2009 3:36 AM (GMT 0)
I've been dealing with a nasty anal fistula (possibly two) and I'm seeing my surgeon Wednesday for an exam under anasthesia. I guess EUA's are pretty common, but I also signed the little paper saying he had freedom to take more agressive action. It's funny, but in the past two days I feel like my second round of antiobiotics have actually finally started kicking in as I have much less pain and drainage from the fistula. Hopefully this will be good news for him and he'll let me know. I'll keep you posted since it sounds we're in the same boat.
Posted 6/8/2009 5:39 AM (GMT 0)
I have horse shoe fistula just next to my rectum. It is communicating with my J pouch and root of penis. It is very painful and always leaking for the last 4 years. The doctors have not been able to provide any proper treatment so far. Quite painful. I will take guidance from all of you for its treatment. Thanks
Posted 6/8/2009 6:51 AM (GMT 0)
Actually Jennifer I beg to differ that Fistulas aren't that big of a deal, .
for some of us they have been life threatening.
Tess
Posted 6/8/2009 4:23 PM (GMT 0)
Thank you, for your responses, I have an appointment with my general doc tomorrow as this ? abcess looks like it may be forming into and ulcer, I have a temperature, but I'm a bit worried as I am on pred at the moment and the last two times this happened they developed into fistulas, (the ones waiting for surgery). Is ulceration normal?
Posted 6/8/2009 4:31 PM (GMT 0)
I never showed granulomas either. Originally dx as UC but as time went by things like anal tags and my fistula as well as skip patterns led them to a final diagnosis of Crohn's. My Crohn's has never been active in my small intestine. The worst of it (more solid inflammation) is rectal, but I do get skip patterns with ulcers in the ascending, transverse, sigmoid and cecum.
Posted 6/8/2009 4:33 PM (GMT 0)
?skip patterns?
I do not experience diarrhoea or frequenty bleeding, so I'm not sure my symptoms are in line with the diagnosis?
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