Abscesses, Fistulas & Surgery

I'm new to the forum and am looking for answers because my condition with Crohn's has gotten so bad the doctors say surgery is my only option.

Over the last year I have been in and out of the hospital with internal abscesses on and around my psoas muscle causing me pain and difficulty walking. Each time I get hospitalized and they put in a JP drain to drain out the fluid. The cultures for the fluid never grow anything, so its sterile, but they still start me on aggressive antibiotics for 6-8 weeks via an IV so a picc line is placed each time. My stay in the hospital is about a week and then I continue with homecare until I'm done with the cycle of IV antibiotics. During this time I cannot be on any biologics because of the abscesses. As soon as I get better about 2 weeks later the abscesses start to come back and I head back to the hospital. This vicious cycle has been going on for about a year and a half, but this last time it's come back fierce. I now have multiple pockets of fluid all over pelvic region along with multiple fistulas. A lot of posts I've seen talk about fistulas coming out through the skin but mine go from the small intestine and connect to different organs. For instance one from the small intestine to the colon, to the large intestine, to the ovary and another one looping around back to the small intestine. This time I was sent home with just a drain and they want to follow up with surgery after the abscesses clear up to remove part of the ileum and a small section of the diseased small intestine. They will also clear out all the fistulas.

I have never had to have a major surgery like this and am very nervous. Is this truly my last resort? Has anyone had fistulas like this clear up on their own with medication or is surgery the only option? Any advice would be much appreciated and if anyone has had anything similar to this happen to them I'd love to hear from you.

I would DEFINITELY give Remicade a try, and fast. It's extremely good in helping fistulae and abscesses heal without needing much surgical intervention.

Most definitely Remicade can.
Surgeons only know surgery
Get the infection cleared, check your WBC
11or less is good 12 might be ok,
And go straight for the remicade possibly a double dose.
You might even want to throw in some MTX to help.
The problem with surgery is it isn't a cure and for most a temporary respite.
Good luck

I had surgery about 4 years ago this summer and it was truly the best decision I ever made. I had an intra-abdominal abscess about the size of a golf-ball that turned into a fistula that drained on my stomach. A CT scan showed that I might have a fistula into my bladder (never had any symptoms or UTI's), so they put me on Remicade for a few months to see if anything would heal. It made my stomach fistula heal and reopen like crazy. Eventually, I started going septic and got frustrated enough to schedule surgery.

Long story short, I had a bowel resection and have been in remission ever since. I would consider surgery again if I ever flare up like that again.

As far as I remember, I believe Remicade will help heal internal fistulae. But I would give surgery a long, hard thought because once the diseased portion is gone, you'll be able to truly heal.