HealingWell
Search Close Search
☰

Perianal Crohns

Support Forums
>
Crohn's Disease
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/13/2015 10:46 PM (GMT 0)
Have seen an old thread on this topic but I have a more specific question:

Have Crohns for 45 years, repeated blockages, fistulas, bowel resections, anal fissures and so on.

For the last two years had a lot of anus inflammation, both my GI and Dermatologist do not want to specifically rule that it is Crohns, they also think it may be a skin condition called Lichen Planus. For those of you that have Perianal Crohns I want to describe what I have and see if it is what you have.

I have massive raw skin around the anus, it has been like this for 2 years and does not seem to heal. What makes it look like Lichen Planus is that on each side of the anus there is a raised ring of skin forming and oval around the anus. They itch like crazy and I use Prax Lotion which helps for a couple of hours. This swelling is constant, it is not growing. There is an ulcer right on the inside of the anus that is not healing either. The main problem is the raw skin that reacts very abruptly to the cortisteroid ointments that I apply.

Question: For your perianal Crohns, do you have this ring or are there more like patches and bumps, any answer will be very helpful. Does it itch and bleed on the outside ?

Post Edited (Fernando) : 3/13/2015 8:03:50 PM (GMT-6)

Posted 3/14/2015 11:24 PM (GMT 0)
Welcome to Healing Well, Fernando! What you have going on sounds painfully annoying, bothersome abd awful to deal with. I don't have lichen planus but I think there was one member, maybe two, that have dealt with it. Hopefully they will have come along soon.
Posted 3/15/2015 3:26 AM (GMT 0)
Thanks for your response, I will get really lucky if I find here a Lichen Planus member. I was looking for Perianal Chrons people: how does it look and feel like in you ?
Posted 3/16/2015 1:16 AM (GMT 0)
Hi Fernando,
When I was in active disease I had excruciatingly painful rectal-vaginal abscesses. I remember seeing red bumps on the outer skin around my anus, but it's been many years so I can't remember more specifics.
Sitting on a sitz bath filled with hot water & Epsom Salt was helpful for me & then I would place some healing gel on a cotton pad & place it on my anus. I used a mineral gel from a company called Nature Rich (found out about it from a friend who was selling their products). At least this would help temporarily ease the pain & keep the abscesses from getting worse. In my case what finally made them go away was the antibiotic Cipro.
Wish you success in finding a way to ease your situation.
Posted 3/16/2015 3:13 AM (GMT 0)
Hi,

Wow, 45 years is a long time. I'm at 34 years. I have periannal crohn's also. I have had an ulcer the size of a 50 cent piece in the rectal area. I also suffer from periannal abscesses and fistulas. I haven't had what you are discribing though. Inside hemorroids yes. I think I would see a colorectal surgeon.

All the best,
Julia
Posted 3/16/2015 4:14 AM (GMT 0)
Well, I don't have lichens, but over the last year or two, I've had more problems in this area. The doctor said it may be because the crohn's has returned. I have a little lump the size of a piece of rice on one side, my anal area is raw and it doesn't seem to heal either, so I blot and then gently wipe because it burns that bad. Sometimes very itchy. When I pass bowel movements, this area feels like I'm passing glass fragments, that's how painful it is. Sometimes the area is swollen with a pertruding anal opening. When I complained, the doctor said I have a small fissure, boy, it feels more like a paper cut that won't heal.  I wonder if what you are describing to some point is also indicative of an active crohn's inflammation?

Hope you find the answers you are looking for. 

Post Edited (dorri) : 3/15/2015 10:19:04 PM (GMT-6)

Posted 3/16/2015 10:36 PM (GMT 0)
Yes it is painful, I apply cold packs and seems to stop it for a few hours. I also use Prax which is an anesthetic lotion. The rings have inside raw skin that does not heal. When I apply cortiosteroids ointments after 3-4 days it goes raw and bleeds so I limit the use of cortionsteriods.

I have had fistulas, fissures and blockages, they all led to surgery. But what is happening to me know is a 24x7 ordeal that does not go away.

There are times when I am sitting, particularly in the car where I don't itch or have pain. I treasure those moments.

This week I am back to the dermatologist and try to understand where he believes is Lichen Planus, it may be because of the rings with a clearly defined border. I will then ask him what will lead to thinking it is Crohns. In both cases the skin treatment are corticosteroid oinments but if it is Crohns once Entyvio takes effect it may reduce the symptoms. After doing research Lichen Planus may be a result problems with the immune system of taking Humira which I took for 4 years at weekly doses.

I am also seeing a proctologist that has done hundreds of surgeries and he is used to seeing Crohns tissue all down the line, to me this will be the defining moment or him ruling it is Crohns, I hope he does not get into the same bandwagon as the GI and dermatologist thinking it could be either Lichen or Crohns. Then I am back to the beginning. There is a skin biopsy that can be cut, but it may require stitches. Ouch !

Post Edited (Fernando) : 3/17/2015 12:12:40 PM (GMT-6)

Posted 3/20/2015 10:04 PM (GMT 0)
Well the final to doctors voted on my anal condition. The first doctor, a dermatologist, backed off the Lichen Planus and said that I had Lichen Simplex Chronicus which is a fancy term for Acute Dermatitis. He did not see deep inflammation on the skins with Granulomas which are classical to Crohns.

The second doctor, my rectal surgeon said that I had Crohns related inflammation due to the decades of diarreah which I have had.

I had been on cortiosteriods which after a few days at a time it caused more rawness and bleeding. They asked me to stop them, keep the area dry by inserting a cotton small plug in my anus to prevent leakage into the area. The dermatologist asked that I should try Desitin or Balmex ointment to protect the area from each bowel movement. This has helped substantially and has reduced the itching to almost nothing.

So this whole Lichen Planus theory was a waste of time. Just about every digestive related problem comes back to Crohns: when I had bloating and cramps it was from Crohns, when I had diarreah and bleeding it was from Crohns, all the fistulas, abcess, ulcers in the digestive track it was Crohns. Just about everything bad I've had down there it was Crohns, so I am back to my beginning theory: Consider Crohns on all these related conditions.
✚ New Topic ✚ Reply