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Crohn's Disease Forum » General IBD Discussion » Question about fistulas


06-14-2017, 03:23 PM   #1
Sophabulous
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Question about fistulas

Hello!

Forgive me, I'm still a total noob about some of the complications of Crohn's but I like to keep it in the back of my mind. I understand that not all Crohn's disease is fistulising and also that ulcers can become fistulas.

Are fistulas always formed from ulcers or can they develop in other ways? Can you theoretically have ulcers but not ' fistulising disease' so they never progress beyond that stage? I'm trying to wrap my head around where I'm at!
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Diagnosed severe Crohn's of the Duodenum, Terminal Ilium and Cecum.

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06-14-2017, 03:37 PM   #2
ronroush7
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I could be wrong but i think that some fistulas can develop from abscesses.

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06-14-2017, 04:00 PM   #3
Tuff
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They can develop from abscesses or ulcers. Mine were from ulcers.
http://www.mayoclinic.org/diseases-c...s/con-20032061
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Stelara, Warfarin, calcium, Vitamins B12, D.
Previously: 5-Asa, Cipro, Flagyl, Prednisone, Aza, Remicade.
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06-14-2017, 04:12 PM   #4
Sophabulous
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Ok thank you both! Do abscesses develop from ulcers too? My consultant is considering a biologic for me, but is on the fence about whether I'm bad enough to need it. My inflammation has gone from severe to moderate, but only because I had just finished a pred taper when I had the colonoscopy. Azathioprine has failed and I have lots of ulcers so I don't see what other option I have if I want to avoid complications down the line! :-(
06-14-2017, 05:41 PM   #5
Tuff
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I don't know if abscesses can develop from ulcers, not sure how I got mine. If the ulcers get bad enough, you can have a perforation, but I'm thinking that is pretty rare. Did he give you any other options? You do need to get the inflammation and ulcers under control before they get worse.
06-14-2017, 05:56 PM   #6
Sophabulous
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I don't know if abscesses can develop from ulcers, not sure how I got mine. If the ulcers get bad enough, you can have a perforation, but I'm thinking that is pretty rare. Did he give you any other options? You do need to get the inflammation and ulcers under control before they get worse.


I have no idea what's going on really, I'm in the process of trying to change hospitals for that reason! Basically I don't have 'flares' as such, but I'm constantly grumbling. As my Crohn's is in a rare place I have fairly minimal symptoms compared to most, but that means it's very deceptive and only scopes will show what's going on. All bloods and calprotectin etc. are *almost* normal.

I'm worried I won't be awarded the funding required for a biologic here in the UK, but at the same time they can't leave me as I am. Even with my consultants backing I feel I'm unlikely to be awarded the funding as my tests all look pretty much normal other than colonoscopy? I have loads of ulcers though, and I'm just worried that they are going to deny me care now, only for me to need much more at a much higher cost in future. I love the NHS but it can be very shortsighted in its forward planning with these things due to underfunding etc. I'm just worried it's going to take me developing a complication for them to 'justify' spending this money on potentially preventative treatment. That wouldn't be good for any party involved, but it seems to be the road they are taking right now due to the current situation with austerity etc!

:-(
06-14-2017, 06:08 PM   #7
Tuff
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Maybe you need a second opinion. Initially, I got Remicade for only three months, then it was extended. My Stelara is good for a year. My doctor really pushed for it though, I don't think he was going to take no for an answer. If your doctor is on the fence, that's not going to help. Hopefully you'll get some answers, try not to stress about it.
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