Can anyone help re life with a seton drain please??!!

Hi there,

I'm Ali, 41 and living in Chesterfield.

My Christmas was turned upside down when I was taken ill and operated on to remove/drain a large perenial abscess. The doctor fitted me with a seton drain on 29th December. I've not been given any particular reason for what caused the abscess, whether it was a one off or is a symptom of something else.

Six weeks on I feel totally alone, GP hasn't answered my questions fully and I've had one follow up with the consultant but I saw a registrar who's bedside manner was lacking and he didn't really answer my questions either. The 4 district nurses I saw had never seen a seton so couldn't really help either!

If anyone has the time to answer these questions I'd be very grateful!

1) Can I work with a seton drain in? I'm a teacher - lots of standing up, reaching up, bending down, carrying heavy books etc.

2) Is it normal to feel a "throbbing" in my back passage (presumably where the drain is anchored, if I understood the consultant correctly).

3) I'm using gauze squares to catch the pus, wedged between my butt cheeks. I change them several times a day but when I walk any distance they often become dislodged. Does anyone have any alternatives to gauze squares?

4) Is it okay to have a bath? At the moment I've been showering only.

5) Is it normal to get intermittent stabs of pain from the wound area ? It doesn't happen often but when it does it takes my breath away (one more reason why I'm nervous about going back to work!)

6) Sorry if this is tmi but the clean up operation after a poo involves cleaning the area with wet cotton wool balls. Can't see me doing that in the loos at work!

7) I've been getting acute pain in my hips (particularly the right one), in the actual bone rather than around it. Is this normal / related to the seton?

I'd totally lost and alone and due back at work next week. I've got a GP appt for FRiday so will be asking these questions (again!) and hopefully get some answers this time. Many thanks!

Ali x

Okay so I've figured how to read the other threads in this forum and it seems I've got an easy ride compared to many of you. Some questions answered too from other threads so thanks!

Hi Ali. Not sure which answers you have but I'll answer the questions I know about.
-Yes you can definitely go back to teaching and most daily activities with your seton. Just check since there might be come exercise that you should limit.
-I used sanitary pads for the drainage and sometimes used cotton (the flat squares) but it also moved around. I just changed my pad a few times during the day and wiped the area that was wet. If it's irritated a lotion called Baneol was helpful to wipe around the irritated area.
-It was OK for me to take baths and I found that it helped. I sometimes took sits baths with Epsom salts. You should check with your doctor, though.
-For when you go back to work, try to get baby wipes (make sure alcohol-free) and you can wipe your bottom area with those. Kandoo brand makes flushable ones so maybe you can find those near you. I had a little bag that I'd keep the wipes in and bring them to the bathroom when I needed to clean up that area.
-As for the pain you're having I also sometimes had intense pain and then it would subside but I never was able to do much about it. If it got really bad I sometimes used pain medications.

Good luck and hope you start feeling better soon and can get used to your seton.

I agree with the above, for clean up, I stayed close to the tub and would go wash up after, if not it is hard to clean up. So, yes, do limit yourself for the first two weeks at least. I always also lose the tube, the doctors tend to get irritated, but I walk as much as I can, pain and all. It works, do the bath tub soaks, the little zaps of pain, the larger zaps of pain, rest as often as you can, but also get out and move as much as you can.

Hi Ali! Lots of good advice already.
My son has 2 setons placed at the moment & had one last March as well. None of it is fun but you can manage it. The main point is to keep it as clean as possible.
You will be fine to go back to work.
When he is home & has a BM he pops in the shower & washes off. A hand held shower head is a good thing to get if you don't already have one.
Lots of people do sitz baths but his surgeon said showers only because he doesn't want bacteria flushing up inside. His is a crater at this point, so it's very open.
He does wear a pad shifted toward the back. And when he is out he carries flush able wipes then showers when he gets home.
The biggest problem he had last time was that if he did too much running around the "good part" of his bum cheek would get irritated from the loop rubbing.
Hope you are on the mend & have a quick recovery!

Thank you all so much! You've been more helpful than any of the medics I've seen. MUch appreciated.

Imodium can help. You will need to research it. It slows your intestine and can constipate you, but the output from the drain will be much less (assuming the output is intestinal fluid). Imodium made my life bearable, but I take anywhere from 5 to 20 per day. The bottle says no more than 2 per day, max of 2 weeks. I've been taking it for about 5 years in heavy doses. The effect of the drug lessens after time and it will seem as though it doesn't work any more. You'd really have to play with your dosage to avoid constipation (which could lead to hemorrhoids).

If you need something to absorb the fluid, use feminine pads (preferably thin ones. If you have multiple drains you can overlap two pads slightly and use duct tape to combine them into one pad). Tape them over the fistula with durable cloth tape (3M). It will hold. The feminine pads are extremely absorbent and also absorb odor. I put duct tape over the sticky side of the pad to keep it from sticking to my boxers.