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Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Unknown Issue? Expert opinions?



08-20-2012, 06:08 PM   #1
Trevor
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Unknown Issue? Expert opinions?

So I'm feeling REALLY good overall. But the very bottom end of things (rectum/anus) not so much. First time this has really been an issue.

Every doctor I see has said something different.

GI said I may have an abscess and skin tags and gave me the regular antibiotics (this was months ago) which did nothing at the time and then my GP diagnosed an anal fissure recently and said it should heal on its own. And then a couple of days ago things were unbearable and the doc at the walk-in clinic had no idea, mentioned hemorrhoids, mucus discharge and contact dermititus (way to really narrow it down there, champ) and gave me procto-something cream and suppositories that do seem to help a bit.

This is SUPER frustrating as I feel really, really good for the first time in years. Chnaged my diet, quit Imuran and Asacol and things are really good.

So basically things are just very inflamed in that specific area and it hurts a lot (sometimes with a minor amount of blood) when I have a bm. There's a small sore/potential fistula? above the anus and then just general skin irrational all around (hard, bumpy rash in some areas).

I'm at a bit of a loss at this point and hearing some of the horror stories on here is more than a little concerning. I'm too close to being healthy to lose it now.

Suggestions? Thoughts?
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08-20-2012, 06:21 PM   #2
Jennifer
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What test/s did your GI do to say its an abscess and skin tags?
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08-20-2012, 06:49 PM   #3
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Visual inspection. The skin tags I can even feel/see so I'm pretty sure they are there but I don't think they are causing any of the current issues (been there for years now).
08-20-2012, 07:14 PM   #4
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Have you called the GI back to let them know that its not any better? What did they say? Also let them know what the other doctors said and suggested and what hasn't worked thus far.

I don't like the GI saying that you "may have" ____. You may need a scope done and possibly a large bowel series (or another test that's less uncomfortable like CT or MRI or MRE). At least the scope will show what's really going on inside and then go from there. When was the last time you had a scope?

Also out of curiosity, why did you stop all your meds?
08-20-2012, 10:25 PM   #5
michaelearnest
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are you sure its not hemorrhoids? I have had several bouts with them after bouts of diarrhea. They last a couple of weeks and heal up with Prep H.
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08-21-2012, 11:08 AM   #6
Trevor
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Could be! I Really have no idea what it is other than I know things are very inflamed in addition to whatever the actual problem is. It has been 6+ weeks though so whatever it is it's persistent.

I made an appointment with my GI but it takes about 4 months to get in to see her.

I stopped all my meds because they had very little effect on my symptoms (Asacol never did anything, Imuran may have but not enough to justify the side effects and risk of cancer).
08-21-2012, 06:43 PM   #7
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This may sound gross (and I apologize) but I thought I'd ask as I seem to be going through something that sounds similar. Do you ever feel like it pops and drains? I have quite a bit of experience with abscesses as I just went through two major surgeries for them in December of 2011 but I now have a small lump on the opposite "cheek". It sounds similar to yours in the sense that sometimes it feels inflammed but just tonight I tried putting a small amount of pressure on it and I think it may have popped. It feels rock hard so it does hurt to push on it when it's present but I'm almost positive I pushed on it and it popped. If not it's a huge coincidence that I got some sort of drainage right after applying pressure.

Does that sound similar to your problem at all? I've had the abscesses like I said and this doesn't feel like those did
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08-21-2012, 08:49 PM   #8
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I had a similiar issue a few years ago. My GI prescribed a lydocain(spelling) ointment which helped tremendously with the pain. I ended up have the area surgically repaired. Due to inflamation and the disease had reduced in size which meant every bm caused it tear or get reinjured.
08-22-2012, 02:46 AM   #9
Trevor
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@Kwalker, not really, no, it's very constant and is more soft than hard, more like inflamed tissue I'd say.


New development: took a good look around the area and found a small pinprick sort of scar/hole that I am pretty sure was either a fistula or abscess from about 15 months ago (thought it was a pimple at the time despite the odd drainage (blood and pus for several days, yuck). This preceded a very bad flare that left me on the couch for a couple of months and I lost about 1/4 of my bodyweight.

Remembering all this now, this is pretty much how things felt down there when I was flaring badly last time, there was just also so many bad cramps and other symptoms that I didn't notice as much/was too weak to care.

So my new theory is that it's not anything other than very bad inflammation and soreness and I am actually in a flare but since I've changed my diet and meds it's just confined to the lower end of my gi tract. The fact that the rest of me is healthier and I'm actually having formed bm's rather than soup is probably also not helping in this instance.

Back to the clinic tomorrow it is then.


Thanks for the brainstorming! It's so much easier to deal with doctors when I have a solid theory of what's going on rather than just showing up and saying my butt hurts :P
08-22-2012, 11:01 PM   #10
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Funny story.

The doc prescribed me a whole pile of Pred (two weeks at 50mg and then taper) and Cortifoam without doing any tests or even examining me for that matter.

Happy 'cause that's pretty much what I wanted but disturbed by the wanton attitude.

Can't wait to get back and see my regular GP next month.
08-25-2012, 10:51 PM   #11
Danu
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I hope you are feeling better by now. If you are still in pain, maybe a sitz bath would help relieve it a bit? Also, what about stool softeners to help make BMs less painful? Good luck to you, having anal/rectal pain is not a fun thing.

Oh also, I just had a seton placed for a fistula. Before going under the knife I had a perianal abscess that was draining. The doctor gave me lidocaine (sp?) cream to help with the pain. After the seton placement he gave me calmoseptine cream, which is amazing stuff. Really relieves discomfort and pain.

That's my 2 cents : )
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08-27-2012, 10:22 AM   #12
Trevor
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Thanks! I could really go for some lidocaine right about now :P On the other hand I do think it's getting better, fingers crossed.
08-27-2012, 11:38 AM   #13
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So I'm feeling REALLY good overall. But the very bottom end of things (rectum/anus) not so much. First time this has really been an issue.

Every doctor I see has said something different.

GI said I may have an abscess and skin tags and gave me the regular antibiotics (this was months ago) which did nothing at the time and then my GP diagnosed an anal fissure recently and said it should heal on its own. And then a couple of days ago things were unbearable and the doc at the walk-in clinic had no idea, mentioned hemorrhoids, mucus discharge and contact dermititus (way to really narrow it down there, champ) and gave me procto-something cream and suppositories that do seem to help a bit.

This is SUPER frustrating as I feel really, really good for the first time in years. Chnaged my diet, quit Imuran and Asacol and things are really good.

So basically things are just very inflamed in that specific area and it hurts a lot (sometimes with a minor amount of blood) when I have a bm. There's a small sore/potential fistula? above the anus and then just general skin irrational all around (hard, bumpy rash in some areas).

I'm at a bit of a loss at this point and hearing some of the horror stories on here is more than a little concerning. I'm too close to being healthy to lose it now.

Suggestions? Thoughts?
Sounds like hemmeroids to me Trev, I get them going when I have difficult bowel movements or diarrhea. When you first notice this, put a soothing ointment on right away and keep it on until you are healed. Every time you go, wash with a baby wipe and dry gently and reapply the cream. (A&D ointment or even Baby rash cream works great ). Try it and see if it helps you. The blood is just the hemmoroid bleeding when you go. Always pat when you wipe.Try not to rub real hard. This will get it bleeding more as I've found out. Hope this helps you.
08-29-2012, 12:33 PM   #14
Trevor
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Hmm. Now that the flare has calmed down and things are a bit more obvious I'd say you may be right.

GP appointment on the 10th of Sept. and doing a liquid diet for a few days to try and give everything a bit of a rest.
08-29-2012, 06:54 PM   #15
723crossroads
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Hmm. Now that the flare has calmed down and things are a bit more obvious I'd say you may be right.

GP appointment on the 10th of Sept. and doing a liquid diet for a few days to try and give everything a bit of a rest.
Hope it all works out fine Trev. Keep us posted,ok?
09-05-2012, 02:39 AM   #16
Trevor
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A bit more clear now that the pred has really kicked in.

Almost certainly an abscess which is either draining or has become a fistula, I can actually see the hole now (in addition to some form of hemmeriods).

Using oil of oregano to combat the issue until my GP appointment next Monday.
09-08-2012, 02:24 PM   #17
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Thanks! I could really go for some lidocaine right about now :P On the other hand I do think it's getting better, fingers crossed.
Hi Trevor,
You can get xylocaine jelly from the pharmacist without a script. All the best.
09-08-2012, 04:09 PM   #18
KWalker
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Smallfry : is that xylocaine a numbing gel as well or no?
09-08-2012, 06:49 PM   #19
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yes, it's a lidocaine hydrochloride jelly 2%. by AstraZeneca. Hope it helps!
09-09-2012, 07:32 AM   #20
AIjen
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I have a lot of issues in this area as well. I went in for a hemorrhoidectomy (internal) and was told I have skin tags around the anal area and they won't remove them because it's a painful surgery. OK, but they are causing me a LOT of issues - pain, some bleeding, but there are fissures there as well so that's probably what is causing the bleeding, itching, and general discomfort. I do hope you start feeling better there soon! That is a hard area to handle pain in.
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09-11-2012, 09:18 AM   #21
Trevor
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And the official word from the GP is... The Imuran caused an abscess which led to a full-on flare in that general area which led to hemeriods + multiple fissures.

No fistula, which is a relief.

I'm feeling much, much better thanks to the pred and things are healing nicely.

Now to use the pred as a springboard for my diet and exercise!
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