Cutting seton treatment - my experience

I have had IBS symptoms 30+years (never diagnosed by physician other than I have told them and always refused any exams). I had a couple of years with hemorrhoid activity, stool leakage started along with pain and blood at sometimes. Had about 12+ years of this, blood was more recent in those years. I got used to keeping TP in the area to keep myself cleaner. After all this ordeal I have concluded that it is self endued to some point, but there are quite a few risk factors that went into my current situation, which now are unimportant since i have changed many of them.

I got an abscess behind my anal opening in July 2015. It burst after 3 days of agony , night sweats and pain. The ER visit (waste of time after it bursts just to let you know if you DON'T have a high fever or detectable fever and the drainage isn't soaking through pad after pad--make a visit with a surgeon) was an expensive lesson.
They left me alone with little instruction, not that anything would have changed. In the end I got exploratory surgery in December (months later when the fistula never closed). It was a mid level one so they put in a cutting seton.

My initial 1st day was rough, 2nd just "stung" a little bit still. I had first BM at about the 30 hour or so--one large continuous piece, which is way abnormal for me. I was very sick before the surgery and had very loose stools. I changed my diet, started taking a specific probiotic (refrigerated cultures not off the store shelf junk), had a session of antibiotics prior to surgery, and an enema helped reset my bowels a bit. I was assured by this change that I did not have chrones, I only once had a slight fever, but I did get a flavor of what chrones suffering might be like.

It took about a week to have the pain minimized to be able to stand it. I worked with about 800 to 1000mg of ibuprofen 4 hours per dosing. I usually just then took 800mg before bed to sleep good. Every two weeks it was tightened. the first time it untied completely and almost came out from me tossing and turnning while sleeping--freaked me out! My wife was able to grab the short end sticking out the fistula track and pull it back to retie it. That is not a great feeling even if it really didn't hurt that much.

I learned you tape those ends together! Get some sterile tape and tape them! make sure you are careful and pack that stuff so your days activity doesn't untie it, because the knots will loosen if the surgeon is tightening it. I got a portable bidet and took it to work to clean off when I had to. I used and still am using a sitz bath tub. I fill it with as hot of water as i could stand but it would loosen the knots. I learned to tighten them myself over time with one hand. I got the final tightening that cut it out the last step as of recent.

My track was a very straight shot though no weird shape or noticeable branching, lucky that way. Fecal matter will come out with a lot of mucus discharge. That is GOOD this is the cleansing of the body and should happen. Keep a TP pad in between the cheeks and it will pull that mess up. Clean yourself often to soak out the infection area and keep the seton cleaner. By clean I mean that good bacteria need to infest you so I believe the probiotics I am taking helped big time with the healing. Get the BMs under control, 1 or 2 a day and if they are normal they should be one large piece that comes out fast in 30 sec. I even have had an almost clean drop like dogs do--which I have NEVER experience before in all my life. I think the sitz baths are the most important.. carefully swish the water around the area with your hand if you half to be careful but I found I had to touch myself more than a normal person would to get an understanding of the process. I was very careful to wash my hands often and long enough to remove the problem of touching that area. I never had an odor issue I know since I cant wear any scented products or be around them much. Sitz baths and the portable bidet helped me out in that area.
i had 4 visits with the surgeon to re-tighten the seton. The last one was horrible, but it felt good in a way cause iknew i was getting better. I waiting about 2 days and the pain was lowered by then. The surgeon suggested to me to have my wife keep tightening it. The muscles were cut and I did not loose control. Infact if anything I think it helped my soiling problem just a bit.

It was about 10.5 weeks and it cut through the muscles (which was the worst part, I could feel the whole connection getting cut and healing that agony took about 7 weeks before the majority of the pain subsided rest was the last of the flesh and maybe tiny bit of healing with muscles still. Right now with it out , since 2-10-16, i still have an area of skin that is cleaved. Anus does not hurt ever now even with BM (it would burn after BM cause gas would pass and force fecal dirt in the are that only a sitz bath could help. I stil have mucus discharge but it is very very minor in comparison to the beginning and before I had any abscess even.

My plan is to continue the sitz and bidet treatments for quite some time, even after it finishes the scar process. I did have abit of pain or at least sensation in the area couple of days ago but it was from not getting the area clean enough.

Time will tell how this finally goes through. I am hoping not to have any more expensive outlay for surgery again. My total cost was over 12k with all the ER and consults, Ins paid about 8k of that I think. i don't see people even mention costs when they post. I think that should be discussed more...that cost is a mental burden that I feel can slow your healing with worry.

update..

I have had small amounts of discharge still, mucus more--no bad smell as some report in their cases, it is actually clean or sanitary smelling if I clean up good enough from the last BM. Which is the main issue--the amount of work it takes to keep clean.

I have a usb camera for your ears, mouth, etc so I finally thought it was time to get a look at this issue and why it still hurt, burned and had discharge. This without the hassle of taking a doc's word for it and paying more in bills.

I still have a wound area deeper inside that has a red spot, not sure if a sinus is there still leaking or the red spot I was able to see was part of the fistula track that is open that just won't heal quickly because of its location. I could actually see the track was torn open as the lighter skin that was it leading to the outside. One small area looked joined, like it torn below and above but this was possibly joined still--less than 2 mm section. It all was on the surface out of the main anal opening, so I am not worried about the remnants of that track healing. Only the weeping, bleeding parts that seem to be left are the concern now--how much longer until it heals? keeps bothering me.

Has anyone ever mentioned Crohn's disease to you?

Most doctors will suggest a colonoscopy if there is bleeding to check for inflammatory bowel disease (ulcerative colitis or Crohn's), cancer etc. I know several people with Crohn's and colitis, myself included, and they are individual diseases, some have it terrible, others its just an occasional annoyance and symptoms can be very different from person to person. I'm not saying you have one of those but it might be a good idea to have a colonoscopy next time you are having major stomach upset for long periods of time to see what's going on.