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Need some help with Fistula

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Crohn's Disease
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Posted 5/30/2011 12:33 PM (GMT 0)
I have been diagnosed for Fistula 4 weeks ago. I often had blood and pus coming out near the anal area. The doctor mentioned only surgery can cure this but I insisted for alternative approaches. He gave me antibiotics for 5 days, I had no symptoms of fistula for almost 10 days after medication then suddenly I saw blood again. I can see blood not only during bowel moment but even during the day.

I went to the doc again and he said, "I told you antibiotics wont cure, you should get ready for surgery". I have a question here, How did antibiotics control fistula when I was on medication?

Secondly, I have taken a decision to continue using the antibiotics for another 14 days to see what happens. Now 10th day has passed, I can see pus coming out again but no blood. What does this indicate? Is the pus getting drained inside out that's why I see pus? Is my body no more responding to antibiotics?

Please help me this is driving me crazy and I don't have peace of mind.

Thank you very much.
Posted 5/30/2011 2:30 PM (GMT 0)
Hi Mathewrnd and welcome to Healingwell. I do not have experience with fistula's, but have read here alot that most have to have surgery to repair them. Hopefully someone with more experience will be along soon. Hugs!
Posted 5/30/2011 6:44 PM (GMT 0)
The antibiotics are probably controlling the pus, but as far as I know they cannot heal the "tunnel" that the fistula is. The only medications that can heal and close fistulas are the biologics (Humira, Cimzia, and Remicade). I have a fistula and my colorectal surgeon suggested for me to switch from Cimzia to Remicade to close it up, but I'm reluctant to make any changes because I feel OK and have learned to just deal with the fistula. He believes remicade is the very best medication for them. My surgeon is reluctant to operate on mine, because he believes it passes through the sphincter muscle and anything he does surgery-wise could make me incontinent.
Posted 5/31/2011 2:58 AM (GMT 0)
I have a fissure and I had a fistula. After my 3 rd dose os Remicade it appears the fistula has closed and the fissure was considerably smaller. Like Aces High my surgeon is reluctant to operate on mine, because she believes it passes through the sphincter muscle and feels that surgery could make me incontinent. I don't have any experience trying to heal mine with antibiotics but I was under the impression that it would not be effective. I hope yours heals without surgery.
Posted 5/31/2011 4:43 AM (GMT 0)
Thank you very much for your suggestions. Could you please help me understand what Remicade is?

I took a look at my fistula using a mirror yesterday and I can clearly see it a red spot smaller than the size of a needle. Is this how fistula's look for everyone? If I have to undergo surgery, how will they cut it open?

Sorry for asking too many questions, Thanks
Posted 5/31/2011 2:15 PM (GMT 0)
Remicade is an anti-tnf medication that is given via infusion every 6-8 weeks. Do you have Crohns disease? Are you not on any medications right now? With all this going on you really should talk to your doc about some kind of medication. Crohns should be treated at all times. Hugs!
Posted 6/1/2011 5:59 AM (GMT 0)
The Doctor did not mention anything about Crohn's disease. I am not sure if I have it either and I am not under any medication other than using anti-biotics. Will check with the Doctor next week when I have an appointment.

Thanks very much for your help.
Posted 6/1/2011 5:25 PM (GMT 0)
Mathewrnd...I have had a fistula in the past. I did not have traditional surgery, but I had a seton placed. What treatment you have for your fistula depends on where it is and your physicians care. My surgeon did not want to cut open the fistula unless we tried all other options first.
1) tried HIGH dose antibiotic flagyl. It was healing my situla, but I had a bad reaction neurologically to it and had to stop.
2) tried high dose Cipro, but it was not as powerful as the flagyl and only lessened the drainage.
3) had a seton placed. A seton is basically a stran of material that is run through the fistula and tied in a loop. The seton forces the fistual to drain more was also tightened regularyl to shrink the siz of the situla. This was successful for me.

Keep in mind that the use and success of a seton depends on the location of your fistula and muscle tissue involvement. Perhaps you can discuss this option with your doctor to see if it is a possibility.
Posted 6/1/2011 10:36 PM (GMT 0)
Don't take steroids. They exacerbate the fistulas. I had fistulas horribly while on Remicade(which I was allergic to) and Humira. They burrowed through my sphincter muscle and destroyed it. I have a permanent illeostomy b/c of it. You probably should seek a GI specialist definitely, Ask for either The University of Chicago or Mayo Clinic in Minnesota. I have doctors at both that I can recommend.
Posted 6/2/2011 12:25 AM (GMT 0)
I had a perianal fistula before I knowing I was crohner and even though I read everywhere it can't heal from Antibiotics it's what my sergeon wanted to try first and it work. Absolutly no sign of return since last november.
I was on cipro and metro.
Good luck with that !
Posted 6/2/2011 9:25 PM (GMT 0)
I have had fistulas and antibiotics never worked for me. I had a fistulotomy in August of last year and was fine. but now I'm having problems again but with everyone it's different. I've heard of people using setons or Remicade that sometimes will dry it up.
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