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Posted 4/26/2016 9:35 PM (GMT 0)
Hey guys, embarrassing topic incoming! (somehow more embarrassing than telling everyone about our BMs :P)

Two days ago I began to develop what I thought was just a spot near my anus (not on it, but not on the butt cheek either..) but it's gotten more painful and red up until now. I've tried squeezing it to see if pus comes out but nothing happens and it just hurts a lot. I read some threads on here and I'm starting to wonder if it's an abscess but I don't have any fever or anything, I've just been having headaches for the last week which I assume is because I only stopped taking pred last week. It hurts to sit down and when I walk, it's only small but with the redness around it it's maybe an inch big, feels quite solid under the skin and it's hot to touch. I've recently gone into remission after 2 1/2 months on prednisolone, I'm currently just on 4 mesalazine a day, but I don't really know if it could be related to the UC. I've had spots appear there before but they've normally gone after a day or two and they've never been this painful. I was planning to wait a few more days to see if it went down on it's own but following a BM I noticed there was a little bit of bright red blood on the tissue and when I pressed a clean tissue on it and took it away there was definitely blood coming from it.

My question is does this sound like an abscess or something else, and should I see my GP about this or message my GI nurse? Or both?

Post Edited (KatAnimates) : 4/26/2016 3:39:14 PM (GMT-6)

Posted 4/27/2016 8:26 AM (GMT 0)
Hi KatAnimates. Unfortunately, your story sounds exactly like one I could tell about my recent abscess. What you are experiencing is exactly how they occur. It will grow and grow until it pops but it will never go away by itself. It needs attention. Half of perianal abscesses go on to become fistulas. (Sorry to mention that word but you may as well be informed now.) Please bite the bullet and make an appointment to be seen as soon as possible. You will probably be referred to a surgeon who specializes in 'these things.' I wish you the best.

Oh, meanwhile, stiz baths are helpful. /en.wikipedia.org/wiki/Sitz_bath
Posted 4/27/2016 3:56 PM (GMT 0)
Thanks Ari. I read up about fistulas too and that was what got me worried! I booked an appointment to see my GP on Friday and sent an email to my IBD nurse, though I'm not sure what she can really do about it but I was curious if this has been caused by the recent pred lowering my immune system. Fingers crossed I've caught it early enough to have it dealt with before it gets worse :/
Posted 4/28/2016 1:50 AM (GMT 0)
a few years ago I had what looked like a pimple near my anus about half an inch away. I squeezed it and nothing ever came out nor did it go away. I kept bugging my doctor that there was something more to it than just a little red bump on my skin. It turned out it was a partial fistula and needed a partial fistulotomy. It was not fun, they had to open the tunnel 4cm deep and 2cm wide and it took over 3 months to heal and a nurse came by every day to clean and pack the wound
Posted 4/28/2016 7:30 AM (GMT 0)
blksteeda I'm sorry you had to go through that. Was it painful, did it make it hard for you to walk/sit?

Update on my situation: the abscess burst last night while I was sleeping. Lots of blood and it smelt kinda bad, I checked this morning and there's a little red mark underneath which I'm worried could be a fistula. I'm gonna go to the GP tomorrow anyway, hoping she doesn't dismiss it now that it's burst as I don't want it coming back :/
Posted 4/28/2016 8:22 AM (GMT 0)
Sorry about what you had to go through blksteeda. I had it easier (no packing needed). However, I am not out of the woods yet from what I understand. The only way that these things get totally eliminated is to open them and let them heal from the inside out. I hope yours never returns.

Would you believe that mine burst on the morning before my appointment as well? I felt the same way - was my doctor going to be upset that I had let it go that long? (There I was, sitting in the waiting room on a hand towel as discretely as possible in case there was a mess. There was.) I believe I read that continued use of corticosteroids is one of the factors that causes abscesses to form - that and flaring. Yeah, so where are we otherwise...
Posted 4/28/2016 9:20 AM (GMT 0)
Kat: Take multiple sitz baths for a few days.
The idea is that you do not want it to close too fast.
Keeping it open as long as possible will get all the infection out, and chances are
it can then heal properly without forming a permanent track.
The surgery is not fun, been there, done that.
OM

Post Edited (Old Mike) : 4/28/2016 3:30:59 AM (GMT-6)

Posted 4/28/2016 10:07 AM (GMT 0)
Thanks for the advice OM, I'll jump into the bath as soon as I can. I made sure to clean it well this morning in the shower.

Ari - I read something similar that suggested corticosteroids could be the cause, as it suppresses our immune systems. I was only on pred for 10 weeks which I didn't think would be a long enough time to do any long lasting impact. Guess this is another reason to hope I never have to go back on pred :P I also read that immunosuppressants like azathioprine can be used to treat them, is there any truth in that does anyone know?
Posted 4/28/2016 11:30 AM (GMT 0)

KatAnimates said...
blksteeda I'm sorry you had to go through that. Was it painful, did it make it hard for you to walk/sit?

Update on my situation: the abscess burst last night while I was sleeping. Lots of blood and it smelt kinda bad, I checked this morning and there's a little red mark underneath which I'm worried could be a fistula. I'm gonna go to the GP tomorrow anyway, hoping she doesn't dismiss it now that it's burst as I don't want it coming back :/

I won't sugar coat anything, it was extremely painful in the beginning especially when the nurse had to clean out the wound every day. I always took my pain meds before she arrived. I moved a little slow initially, it was fully packed and throbbed. My GI sent me to a colorectal surgeon to check it out
Posted 4/28/2016 11:41 AM (GMT 0)
They will most likely take a "wait and see" approach if no fistula is visible. I had an abscess that became a fistula. After it initially burst, we waited a couple of months and it returned. The surgeon was then able to find the fistula tract. Had a fistulotomy. Good news is, at least for me, the initial abscess was probably the worst part. Although the entire experience sucked. Surgery was painful but you can load up on pain meds, if it comes to that. Count yourself lucky that it burst on its own, having it incised was not fun.

From what I've read, biologics are the best at closing fistulas. Talk it over with your GI.
Posted 4/28/2016 12:35 PM (GMT 0)
How did you guys know that your abscesses turned into fistulas? What kind of testing was performed?

I've had an abscess for many years. The first initial one hurt pretty bad but now they don't. I usually discover it accidentally when I'm showering or when it bursts and it gets all gooey. I've had about 4 colonoscopies during that time and my GI has never said anything.
Posted 4/28/2016 4:21 PM (GMT 0)
Sherry,

Generally, a colorectal surgeon can find a fistula tract with a rectoscope, but its not always easy to see. My GI admits that she is not all that knowledgeable about abscesses or fistulas.

After my first abscess, the surgeon said if it reoccurs, it is likely that I have a fistula, which is what happened. After the second abscess, he was able to see the entry and exit to the fistula. I just went in to see him again for some discomfort in my muscle and he said that he could do an MRI if there is a strong suspicion of another fistula, which, for me, there was not. May be an option for you if you are concerned. If found, your options would be to do nothing, have it laid open, or have a seton inserted.
Posted 4/29/2016 1:48 AM (GMT 0)
So is it typical for most abscesses turn into fistulas? Or can an abscess just be that? I'm curious about this because there are times I feel completely normal down there since I'm in remission but when my abscess returns things feel a bit "hinky".
Posted 4/29/2016 12:11 PM (GMT 0)
The rates are about 50%. 1/2 turn into fistulas, 1/2 don't. I would think that since you have multiple abscesses you may want to investigate further to see if its a fistula feeding the abscesses.
Posted 4/29/2016 3:01 PM (GMT 0)
Saw the GP today who said I should've seen the emergency doctor but also said that it looked more like a boil than anything, she couldn't see any connections so hopefully no worries about a fistula. She gave me some antibiotics for a week and told me to call 111 or go to A&E if it gets any worse again. Feeling relieved! I asked her what the likelihood of it being connected to my IBD is and she said very likely, especially since I'd been on pred up until a week ago. So another reason to dislike pred and avoid being on it again ;P
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