Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Is it possible to prevent an abscess from turning into a fistula?

02-10-2013, 12:40 PM   #1
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Hi all. I'm brand new and so glad to have found this site! I'm also sorry for all that so much of you have experienced!

Here's my story--have had GI issues my whole life, diagnosed with IBS as a teen (early 30s now), Crohn's runs in family, but had a colonoscopy about 6 months ago that was normal. Doc seems to think just bad IBS--boughts of diarrhea/constipation, have to watch my diet extremely closely, abdominal cramping, history of hemorrhoids/fissures for 15+ years. Have had fissures off and on for years but have struggled mightily with it since Oct 2011. Several small abscesses formed in the last year that were healed with a Cipro/Flagyl combo, but the fissure itself hadn't healed since the colonoscopy in Sept (that of course retore it).

After unbearable pain and a lot of swelling earlier this week, saw my colo-rectal surgeon Wed who said I might have an abscess but she thought a thrombosed hemorrhoid. Sent me home with 7 more days of Cipro/Flagyl per my request. I knew it wasn't a thrombosed hemorrhoid--have had several and this was much larger and MUCH more painful. It was indeed an abscess that started draining on its own on Thursday. (It worried me a little that my colo-rectal surgeon misdiagnosed me, but I'm happy for her cautious approach of no cutting.) Has been draining for 4 days, I've been taking multiple baths a day, etc.

Here's my question--do any of you have any secrets as to not developing a fistula (assuming I don't currently have one)? I have read a high protein diet? I eat very little meat, so this will be something I need to work on. Also, were you on antibiotics while the abscess was draining? Will finish my course Tues and not sure if I need more--doc is a little hesitant to give them, and I understand. However, I was running fever with this earlier in the week (again, why the hemorrhoid diagnosis was odd to me) and just hope that 7 days is enough to clear the actual infection.

Thank you all for sharing your stories--it's VERY inspiring. I wish you all the best!
02-10-2013, 09:47 PM   #2
KWalker's Avatar
Hello and welcome! I hope you don't mind that I moved your post to your own thread but I thought it would be much more beneficial for yourself.

After reading your post it really popped out at me when you said you have a fever. How high is it? A fever can mean a serious infection inside such as sepsis so it is extremely important to keep a very close eye on that. I got rushed to the hospital back in 2011 because I had abscess problems and I spiked a fever of 104 which caused my body to go into shock so the paramedics/doctors thought I had sepsis. Thankfully I didn't.

Is your abscess internal or external (perianal)? I only have experience with external abscesses but for me Cipro and Flagyl didn't do much, if anything to help promote healing. I was on several two week courses of the two together and while they seemed to work while I was taking them as soon as the prescription was done and the medicine left my body the drainage came right back. I eventually required surgery which made things so much better for me once I was done. I had a big surgery for my abscesses because mine was huge and extremely infected but from what people say, the normal abscess "surgery" is a piece of cake, and totally worth it.

As far as the abscess turning into a fistula, I personally don't have any experience with that sorry. Mine have never turned into a fistula so I don't know the process in which that would happen, or if it happens in the opposite order and the fistula turns into the abscess. I'll tag Sailorluna because she knows much more than I do about fistulas. As much as I hate to say it though, the drainage can take place for quite some time. We all vary, but I personally have drained for years while others drain for a few weeks to a few months.

Please don't hesitate to ask any questions you may have and I hope you get some answers soon
Age 2 (1992)

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02-10-2013, 10:55 PM   #3
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Thanks so much! My fever has been low enough to not cause extreme concern but high enough for me to know something is going on. However, it has seemed to lessen with the antibiotic course. I'll just cross my fingers that this doesn't turn into a fistula! Don't know if I should be happy that my colo-rectal surgeon (at a very well-known medical facility) said she wasn't sure if it was an abscess and therefore didn't drain it, or if having it drained would have helped. Seems like it may have gotten more of the infection out that way than slowly draining on it's own, but at least I avoided what sounds like a painful procedure.

Thanks again, and I wish you a healthy 2013!
02-10-2013, 10:56 PM   #4
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Sorry, it is peri-anal.
02-11-2013, 06:15 PM   #5
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I've just had experiences with fistulas, so I'm not sure. I'm the same as Kwalker in that Cipro/flagyl don't do much for me.

As for the high protein diet part, I'm not sure if this would do anything. Personally I find a high protein diet too hard to digest so don't think it would be worthwhile even if it did anything for fistulas.
02-11-2013, 07:29 PM   #6
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Hi Cap,
Sorry to hear about your troubles. Sadly, I don't know if it is possible to stop the formation of fistula...

You mentioned a fever, as KWalker says they can get serious quickly with these so please keep an eye on it. Good luck with healing, hopefully it is just an abscess and will not come back

Symptoms since 98
Resection and diagnosis June 2010
3 fistulas
abscess drained 6 times (so far...)
currently 2 seton in place 1 since 9/11 the other 4/14
1 strange small air pocket with an 8 cm sinus track leading into the great unknown
methotrexate weekly
folic acid
2 lomotil
2 Welchol
B12 injections (monthly)

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02-11-2013, 07:48 PM   #7
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Adequate protein levels help with healing so you should make sure you have lots of protein in your diet. When I was in hospital recently i was fed intravenously because I was malnourished from a protein point of view and no-one would operate until I had a good protein level (can't remember what its called on the blood test). If you have active disease in the bowel it may impair protein absorption (it did in my case) so we should all ensure we have extra protein. Protein in the diet also makes us feel more satisfied so we don't overeat (or so I've been told )

you name it, i've tried and failed it! currently on- waiting to see whats new and reducing pred
temp. ileostomy reversed feb 2011, new ileostomy, nov 2012
4 resections plus removal of adhesions etc, recurrent intestinal abscesses
lyme disease, depression, sacroileitis, chronic pain and......Crohn's..........
03-04-2013, 05:10 PM   #8
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Wanted to thank you for your responses from several weeks ago and circle back and let you know that I do have a fistula and will have a fistulectomy in two weeks. If any of you have advice for me before or after the surgery, I'm all ears! I'm dreading the recovery, but if it can help resolve this 18 month long issue, a week of pain will be well worth it!

Hope you're all feeling well today!
03-05-2013, 10:39 PM   #9
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Location: United Kingdom
Hi glad they're going to do something for you, the surgery basically involves laying open the fistula tract and cleaning it out, it is then packed with one of a various number of products that have different things added to promote healing aquacel is one example, the reason this is done is to let it heal from the inside out, as if it healed over at the skin you would be left with a cavity which could abscess. You will need the local nurse to change your dressings daily when you get home, other than that just try and keep it as clean as possible which with where it is can be challenging, is it above , below or to the side of your rectum? Above all good luck and keep us posted.
03-06-2013, 01:45 PM   #10
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Thanks for the response! She believes a fissure is the first opening, with the second being the place where the abscess ruptured about a month ago maybe a half inch about the anus. However, she said she's not entirely sure this is a fistula until she does the surgery/exam under anesthesia to see.

Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Is it possible to prevent an abscess from turning into a fistula?
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