What kills the peri anal abscess??

Posting here as crohns board isn't active and no one has been able to answer there.

Chronic abscessing since OCtober. Copious amounts of disgusting drainage. Soaking through pads every 2 hours at times.

Likely having seton put in next week. (3 weeks ago went for that procedure but the rectum had healed....or so we thought)

What I want to know is what actually kills the abscess? The seton just keeps the tract open but doesn't kill the abscess.

Abx is pretty useless.

Thank you

Are you trying to treat the abscess or prevent it from happening? I'm not an expert on this stuff but I think that you want to treat the infection with antibiotics/drains and then prevent it from happening in the future with biologicals/immunosuppressants.

So if it was me, I'd discuss a combination of the two approaches with the doctor. I'd also tell them that this is been going on too long and you want them to bring out the "big guns" like Cyclosporine or a newer biological like Stelara with antibiotics.

I thought that Humira was supposed to be pretty good about CD abscesses but obviously it's not working in your case.

UB I feel your pain, I have UC so this may not work out for you due to crohn's.

Heat/Heat/Heat, sitz baths as many a day as you have time for and as hot as you feel
comfortable with. I also keep a plastic glass at the sink so I can add hot water when
it becomes too cool,in the bath.
Also antibiotic cream on the area a few times a day.

What might be going on is somewhere in the rectal area there is a tear or split or infected gland,
anyhow what I think goes on is that some stool gets forced into this and causes more infection
when you go. I had one fistula tract since healed, that I actually squeezed a small piece of dried
stool out through my skin. Sorry to gross some people out, but this disease you tell it like it is.

At least yours is draining, back in 1972 had to have emergency surgery, for a large abscess that
would not burst, track opened up again after it had healed, took me years to get it to close.


If you have soft stool or D this probably makes it worse as far as reinfection goes.
Also rectal spasms might cause more reinfection so try to relax when you go and
not strain much.

Now days if I get a abscess my main goal is to have it burst so I can get rid of the pain,
the hot water will help it to burst. For whatever reason after it burst and all the pus drains
out with some help and a lot of sitz baths,antibiotic cream, they usually heal right up.

Another possible is you have a big abscess somewhere and that just keeps draining.
Heat may not be able to get to that.

Good Luck
Old Mike

Actually not taking any woo at this time, not even sure of the brand.

Well if you have internal abscess then I dont know what to do.
I do know that you should not let it get out of control, they can get really big.
My #1 son had one in the tail bone, after he had emergency surgery, the doc said
that there was a grapefruit sized ball of pus.
If you have a high temperature or even a moderate temperature it might mean
that it is time to go to the er. Sometimes things get so out of hand that waiting
can be dangerous. But then again the er docs might not be as good as your own
surgeon.
When my son went, the er doc wanted to do some kind of half ***ed
drainage. Lucky for us, the doc who did my wifes gall bladder happened to be on duty in the hosp.
I knew he was a good surgeon so I had him do it, and all went well.

I do feel your pain.
Good Luck
Old Mike