Recurrent abscess or infection while on seton

Hi all!

I'm 33 yr old female and have been having abscess since 2012. Had my first i & D done under general surgery and it was ok and healed well up till late 2014. After constipation, a lump started to grow which resulted in an abcsess.

So I had another i&d done at the emergency room operation theatre as day surgery. As my mum is a nurse, she was the one that did the cleaning and packing for me every single day.

Then subsequently I had few recurring abscess now and then through out 2015 and it will go away after rounds of antibiotics from GP.

In Sept 2015, I had another abscess growth and went to the emergency and got admitted again. Did another round of i&d with general surgery dept but they did informed me if they find a fistula, will do a seton. However, during the surgery, they didn't manage to find any fistula. I had MRI done and they couldn't see any either. And I had colonoscopy done too and results came back ok.

Just 3 months after that, on New Year's Eve, I chked myself in to yhe emergence room in another hospital and requested to be looked at by a CR specialist instead of being in general surgery again.

So lo and behold, they went through my MRI from the other hospital and suspected a fistula. Did and drainage and true enough, there was a tract and I had a seton in.

It's been almost 2 months now and last week when I saw the doctor, he cleared me from Crohns. And told me the next procedure will be LIFT.

As I hv a spray bidet in the toilet, cleaning has been easy and did my sitz bath after every bowel movements. And after that, my mum or husband will clean the area with saline and put gauze over it. That was the routine.

Just few days ago, I've been having sore around the area and just today while I was cleaning myself, I felt the area around my wound to be thick and harden and it's sore to touch. Just like how it felt when an abscess or an infection develope. Everytime I touch it, it'll hurt.

I Thot I wun get any infection as long as the seton is in? It's still discharging everyday, not a lot but there will always be on my gauze when i clean.

Anyone had a recurrence while on seton?? I'm so worried now.

I've had recurrences while I've had a seton in. If your fistula has multiple branches, you may just need to have a second seton inserted. This is actually what I just had done last month, after getting multiple recurrences!

If that's the case, you should have a seton inserted for this new abscess, and then after that, you could consider the LIFT procedure again.

Inky, Recurrence of pain and infection, depends on the anatomy of the fistula - position of the abscess, IO, and EO. The pain never stopped for me even though I had a seton and the abscess kept flourishing. The anatomy of my fistula was such that seton was of no use in preventing further infection and onset of pain. I have a drawing of the anatomy of my fistula in my blog. There are lot of information - research papers and of that ilk - online and you should go through them. The treatment options for high-anal fistula are limited in western medicine - at least that is what I realized before venturing out of the USA to find a cure for my condition.

AFS said:

Inky, Recurrence of pain and infection, depends on the anatomy of the fistula - position of the abscess, IO, and EO. The pain never stopped for me even though I had a seton and the abscess kept flourishing. The anatomy of my fistula was such that seton was of no use in preventing further infection and onset of pain. I have a drawing of the anatomy of my fistula in my blog. There are lot of information - research papers and of that ilk - online and you should go through them. The treatment options for high-anal fistula are limited in western medicine - at least that is what I realized before venturing out of the USA to find a cure for my condition.

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Every single study done on kshar sutra specifically excludes patients who are immunosuppressed or have Crohn's/IBD from their study. So, while I'm happy that this worked for you when you don't have IBD, it would be irresponsible to recommend to IBD patients.

I've gone through your blog to review the surgeons and links you included, as well as every single study I could find online about this.