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A ruptured abscess that won't heal = fistula?

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#1 gypsyfp


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Posted 07 October 2009 - 06:36 PM

I was diagnosed with Crohns at 16. That was ten years ago.
After a rough first year, Asacol pretty much took care of things for me.
I eat healthy and don't take meds. Diarrhea is not uncommon, but abdominal pain is very rare.
Last year, I discovered an abscess below my vagina. I've had Bartholin Cyst problems in the past, so I thought it might have been related to that. I went to doctors and even they weren't sure if it was bartholin or not. I was prescribed antibiotics and it went away on its own! Shocking, I know!
Fast forward to a month ago, and the abscess came back. Same spot, so I had the same expectations. Boy, I was in for a bigger shock that made me realize how lucky I had it last year. But at least a year ago, I had health care in Canada. sigh
I was diagnosed with a perianal abscess in the ER and given a prescription for the same antibiotics. I was not lanced or cut at all. Most of the internet sites suggest that docs cut first and ask questions later when it comes to abscesses, but not once has any doctor suggested doing anything more than giving me meds that taste like metal.
3 days later, the meds were not working. The abscess was twice its size compared to what it looked like when I went to the ER. After much pain, it ruptured while I was asleep and there was alot of brownish yellow drainage and a whole hell of a lot less pain than before. YAY! Hurray! I thought it was over, but I finished my antibiotics, and it's still there. I guess I drain it when it gets slightly big maybe once or twice a day. Sometimes it's more watery and other times it's yellow like before. Sometimes when I push on it, similar looking fluid comes out of my anus.
I got approved for health insurance for the month of october, (probably because I didn't tell them that I was currently suffering a second abscess) but I haven't been to see a doctor. Mostly because I'm scared, partly because an appointment still costs alot of money even with kaiser insurance.
In 5 days, it'll be a month since it ruptured and it's still there.
Has anybody had an abscess rupture on its own? How long did yours take to heal?
How do you know if you have a fistula? Can you always see it or are some only inside?
If an abscess won't stop draining, does that automatically make it a fistula?
I'm asking for others' personal experiences here.
Does anybody know how much a actually fistulotomy costs? My deductible is $2700, so I'm hoping that if the doctor makes me go through it, it'll costs more than that. That way, I can go to the doctor without having to pay out of pocket everytime. That is, if they don't take away my health care for lying about my second abscess on the app. I only told them about the first. sigh.
I don't see how I can have recurring abscesses and really not be that sick.
Fissures, bartholin cysts, anal itch, hemorrhoids, abscesses, and now maybe a fistula?
Why does it always have to be in the worst place?
I don't know what to do.


#2 HaydnLM


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Posted 09 November 2009 - 05:16 PM

dear gypsyfp

I have had Crohn's since I was 15. I'm now 26.

I have experience with abscesses and fistulas.

Sorry to hear about what you're going through. I know you posted this on the forum a while ago. I'm sorry also that I'm only replying to you now.

It sounds as though you need proper medical advice. I hope you have sought that out, as this kind of thing is not something you are supposed to suffer along.

Let me try see if I can answer any of your questions...

Abscesses do definitely rupture on their own. The collection of fluid/plasma/pus/anything will eventually find it's way out. Normally a surgeon will lance it to speed that process up to empty the collection to allow granulation (healing) to begin.

It depends how long a popped abscess will take to heal. I don't think there is a specific time. It depends on the healing index of your body, and if there is any underlying disease. Try make sure that your body is in optimal health to allow the best chance of it healing.

Will a continually draining abscess automatically form a fistula? Well, the definition of a fistula is an abnormal opening/connection between two or more organs/outside of the body. I don't know the details, but it sounds as though your abscess is not a deep abscess. Although, having said that you mention when you press it, fluid comes from your anus as well, which would mean that the abscess has drained itself peri-anally as well as to the skin. In this case, I would presume you do have some form of fistula or communication between the abscess and your rectum and or anal canal, but it's nothing to stress about. As my CRS said about my fistula's, "things like this heal all the time."

As to the financial questions, I'm sorry but I have no idea what the cost's in dollars would be. I am from South Africa! :(

Unfortunately one of the indications of Crohn's is fistulas. They are probably the worst part about having the disease. Sometimes the fistula's can take a while to heal. As I said, just make sure your body is able to heal by keeping your intake optimum.

I take Azapress, which is an immuno-suppressant. You could ask your Gastro about that. There are also other medications available, called biologicals, but these are only last option choices. I also take Ciprobay, as it has anti-inflammatory properties. At the moment I have a fistula running from where my rectum used to be, to just below my belly button, with a bowel communication somewhere along the path. So, we are both in the poo!!!

By the way, what antibiotics have you been taking?

Hope this helps. Good luck. And remember, stay positive...

#3 mabelle


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Posted 29 December 2009 - 07:58 PM

Hi Gypsyfb,

Sorry about your medical challenges. I read your post and was amazed at how similiar it was to my situation with the exception of the Chrones, I don't have it or any other condition. I"m not exactly sure what a fistula is but I kind of don't think I have that either. I've had a Bartholin Cyst in the past also. I had breast reduction surgery about 1 1/2 yrs ago and have been battling hemmorroids since then. I am also uninsured at this time so I would really like to solve this on my own.

My cycst burst on its own just when I had made the decision to go to the emergency room, I ended up not going but had a scheduled dr. appt. 2 days later and figured it was ok to wait till then. Anyway, there was an incredible amount of thick gooey disgustng discharge, she put me on antibiotics which didn't really work and two weeks later i went back in tried another drug and it seemed to work, but now over 1 month later its bleeding and draining again. Sometimes its bloody and now recently its more yellowy fluid. I can't feel exactly where it's at but she says it right on the rim of my vagina. It's been about 2 months and it doesn't appear to be healing and just wondered how yours was doing and if you had any other info you can pass on.

#4 gypsyfp


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Posted 22 June 2011 - 07:24 PM

Update peoples!
I got a job shortly after I posted this and it gave me health insurance!
I got a GI and she made me go through tons of tests.
To sum up, I had a fistula because of unmedicated Crohn's Disease. She wanted me on Remicade, but the HMO wouldn't approve it because I hadn't been taking any meds for 10 years. I saw a surgeon as well, but he told me it was inoperable because it was too high. He said that 'cutting it out would just create 10 more.'
I finally got my Remicade in May 2010. The fistula healed by July! I was so happy and grateful that I even participated in the Team Challenge fundraiser and ran a half marathon in December.
Shortly after that physical peak, the fistula started draining white pus in January. My Remicade was doubled to 10mg, but it didn't make the drainage stop. Since January, things have become steadily worse. The pus is no longer white; most of the time the discharge is stool, only rarely is it blood. My GI hasn't given me more options. I even had to force her to give me a round of cipro/flagyl when things were getting really bad in April, but it didn't work.
I see my GI tomorrow and I'm going to ask her about the vacuum assisted closure or VAC option. I don't want to have surgery, but I feel that I have exhausted all medical options. I'm moving to New York in August to start school. Hopefully, I get a better GI and perhaps even schedule a surgery for next summer.
Aside from fistulas, I don't have many Crohn's symptoms. I'm relunctant to be cut for something that hasn't really harmed my overall quality of life, but I can't just leave it there, right? What more can I do except surgery, but even then no one will dare to do it because of the CD. I'm stuck and I don't have many options left.

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