Possible Recurring Perianal Abscess

It's been nearly a year of struggling and I'm at my wits end.

First off, I have not been diagnosed with Crohn's yet. I'm going through more tests since my GI seems to not have the slightest clue about what she's doing. She missed Celiac which was clearly evident in all four scopes she performed and apparently also missed an abscess.

Moving on.

Last October I went in to see this GI after suffering through sever digestive issues and she diagnosed me on the spot with hemorrhoids and fissures - more came later but those are not relevant to the abscess I'm struggling with.

What surprised me in particular was that there was a lump about an inch in diameter that seemed too far out to be a hemorrhoid but nevertheless, I went with it - clearly a massive mistake on my part. Months went by and this lump just got bigger and more painful until I could not take it any more. This past month, the 26th of June (a Monday) to be exact, I went in to the ER after diagnosing my self with an abscess thanks to google. Aside from the excruciating pain, it had seemingly burst and slowly started draining, but sure enough the doctor diagnosed me with an abscess then sent me home with pain killers and antibiotics after what may have been a 45 second exam. By the time Friday came around, even lifting my foot an inch off the ground to put a shoe on had me in tears from how severe the pain was.

I went in to the ER again that Friday and was admitted that night because they decided the most humane way to lance and drain it was under general anesthesia in the OR. This may be TMI but the 'head' of the abscess was about the size of a ping pong ball sliced in half and the underlaying mass was roughly the size of a russet potato (I'm still not sure how deep it went). The surgery ended up being more than two hours with nearly 8 oz of pus drained from it and a seton was left in the fistula tract.

It has now been three weeks and one day since the surgery and I am starting to experiencing some of the pain again. There is a red lump forming about half an inch or so off to the side of the incision and the incision itself seems to have turned into a pinkish bump. It's hard to get a good look at it given the position it's in.

I have an appointment on Thursday with a colorectal surgeon who was going to decide wether the seton could be removed normally or if it would have to be done surgically and I don't know if I should wait until then to discuss with him or go in to the ER again. It took nearly five days to get my follow-up with my actual surgeon after being discharged because his staff seems to not know how to answer the phone or return calls so there's no point in trying to talk to him about it.

Does anyone have experience with reoccurring abscess?! I don't know what to do anymore.

Yeah you are really sick and you can't afford to take any chances by waiting (I did that with an abscess and I regret it). Definitely go to the ER if you haven't already. Alternatively, you can call your CRS first thing this morning and see if they will see you today instead of Thursday--tell them the details. And find a new GI that specializes in IBD! Your GI sounds awful.

Good, I'm glad you're going in. Please keep us updated. Good luck.

Are they packing them to help them heal slowly from the inside out. Take lots of sitz baths. Aside from that, the only real option I can think of is to get diagnosed with Crohn's and start medications to get it under control.

Ok so it's been a whirlwind of a week.

I already posted this but I'm doing it again as a full update. I was going to the CR surgeon as a new patient off of a referral from the surgeon who did my initial I&D. My PCP was kind enough to reach out to him on his personal number and got me in first thing tuesday morning. He confirmed the second abscess but because it was so small he did the I&D there in his office under local anesthesia, which did not work by the way, and told me just to dress it as normal and take hot baths. No packing or nothing because it is relatively small. He did have me schedule an appointment with my GI asap for a colonoscopy which I just had done today.

After catching up my GI on everything that had happened since I had last seen her, she goes 'well that explains everything. there was something brewing and we couldn't tell until it showed itself'. Since I first saw her in October, my WBC was through the roof, swollen lymph nodes, and general unexplainable inflammation. Apparently it was the abscess, fistula, crohn's all manifesting or something.

Either way, she confirmed what I already knew, there's fistulating abscess that's draining. Next step is to see her sometime next week to get me started on Humira. I wanted to call today to schedule the appointment but I was so out of it after this procedure that I got home and immediatley knocked out.