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Questions about fistulas

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Ulcerative Colitis
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Posted 2/18/2008 3:18 AM (GMT 0)
Is there anyone on right now (10:15 pm Eastern time) who might have some information about fistulas? Bratcat's brother has what is probably a fistula. Not sure where it is coming from. The doctor put him on Flagyl and Levaquin. Told him to try to take epsom salt baths. He started the meds on Thursday evening. He is supposed to see the doctor on Friday. Tonight he asked me to call the doctor tomorrow to see him because he thinks it may have gotten bigger (pain is still the same). He decided to take an epsom salt bath. Well something popped down there. He said there was pus. Now there is blood. And he is trying to stop the bleeding. Anyone know what to expect? Should the bleeding stop? Is this a good sign or a bad sign?

Thanks.

Posted 2/18/2008 3:29 AM (GMT 0)
Hi, I'm here in NJ - ironically, I think I'm havng something going on like that. There's some tissue and blood for the first time since I started the Pred - it's related to the rectum, I believe. No loose stools, just sore and some blood and tissue. I'm putting in a call to the doc for some suppositories. If he won't give them to me, I'm getting a second opinion. I've been so good, given up foods that I love and now this. I'm very bummed tonight. Hope things get better - did you call the doc?

Posted 2/18/2008 3:30 AM (GMT 0)

It sounds, based on your description that he had an abcess and now it has fistualized (broken through). 

Sue

Posted 2/18/2008 3:33 AM (GMT 0)
I had a fistula ten years ago in the midst of (or caused by) the worst flare I ever had. He should see his GI again. It sounds as if he might have an abscess if there was pus. If so, he needs to have it drained as well as antibiotics. A fistula isn't painful (at least mine wasn't). I also had an abscess about 4 years before that. It was very painful.

If it is a fistula, there are also medications that help close it up. I was on cyclosporine which made a difference. Since then (1997), infliximab has been used with success. In any event, he needs to see the doctor again.

By the way, I had been told that if you have a fistula and/or an abscess, it is a sign of Crohn's rather that UC. That is not necessarily so. I have UC.

M
Posted 2/18/2008 3:35 AM (GMT 0)
Sue,

Is it okay that it "popped?" It is still pussing with a little blood, but he says he thinks it's getting smaller. I could have him sit in an epsom salt bath again but do you think it will "burn" from the salt?

Thanks
Posted 2/18/2008 3:42 AM (GMT 0)
No it won't burn from the epsom salts, that's helpful for them...sounds like an abcess...

and yes, abcesses and fistulas are common to crohns not UC...UC and CD are not always DX properly, especially for those who have crohns-colitis which is when CD is affecting the colon like UC does, then it can be even harder to get a proper DX and believe me, there are CDers out there that have had ONLY their colon/rectom affected by crohns, not every CDer gets CD in other parts of the GI tract.

Usually that's why when a UCer has problems with fistulas or abcesses it's a good indication they may have been misdiagnosed.

:)
Posted 2/18/2008 3:46 AM (GMT 0)

So should I try to get him back into the bath?
He says it is slowing down a bit on oozing. If he can get it to stop for the night, I will call the doctor first thing in the morning.

Posted 2/18/2008 3:48 AM (GMT 0)

Yes, he should be fine now that it popped but he does need to follow up with a GI or a CR surgeon.  Although fistulas and abcesses are more commonly found with CD patients, this does not mean he has CD.  about 20% of UC patients will develop an abcess or fistula.

Sue

Posted 2/18/2008 4:05 AM (GMT 0)

Can you tell the difference between an abcess and a fistula? I understand the difference on paper but is it something a regular person can tell?
Also, do you think it is wise for him to wear a sanitary pad tonight? (He brought it up tongue ) This way if anything leaks, he is protected. Or will it irritate it more (or be unsanitary).

Again, thanks for helping. It's great having such a strong support system here.

Posted 2/18/2008 4:18 AM (GMT 0)
From what I have heard on the CD forum, people wear gauze over the abcesses so a pad should be ok. I would double check on the CD forum.
Posted 2/18/2008 5:39 AM (GMT 0)

Thanks for all the answers and support. My son bathed in the epsom salt bath again. It didn't hurt. He was still leaking after so he is wearing a pad to bed. Got to love a kid who doesn't complain about wearing his younger brother's boxer/briefs and a sanitary pad. The whole ordeal wiped him out so he went to bed. He said it still hurts a lot but not the same pain as during the day. More so because it "popped". He thinks the abcess is a bit smaller. I'll call the doctor in the morning.

Have a good night all.

Posted 2/18/2008 2:11 PM (GMT 0)
Remember too that abscesses and fistulas can occur in the absence of IBD. Sometimes it's a chronic infection of the perianal glands that leads to fistula formation. Let's hope this is what's going on with your son, Bennie.
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