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Greeting fellow j-pouchers!

I am looking for advice on how to treat a pair of anal abscesses prior to seeing a doctor in hope's of keeping the abscesses from getting any worse in the meantime. One abscess is draining in at least 3 locations, yet the other one is much deeper and has not begun draining.

My GI specialist was unable to see me on such short notice, so he sent me to the ER last weekend. The ER doctor said the abscesses were too close to the anastomosis for him to do anything about them, so I was referred to CR surgeon. The surgeon is trying to squeeze me into his schedule, but it may be after the Thanksgiving holiday.

In the meantime, what can I do to keep the situation from getting worse? Can I do sitz baths with Epsom salts if one abscess is draining? Can flagyl gel be topically applied, or is ph going to be an issue? Is there anything I can apply on the abscesses? What's the maximum dose of cipro I can take until I see the doctor?

Any guidance would be greatly appreciated!

Original Post

Sitz baths (hot) should help the one that’s draining, with or without Epsom salts. If you’re lucky, the hot soaks might draw the deeper one to the surface, but that sounds like a long shot. Antibiotics tend to be somewhat ineffective for abscesses, because there is no blood supply to the abscess, and blood is how antibiotics travel to an area of infection. Nevertheless, the highest dose of oral Cipro that tends to be used for any purpose is a 750 mg dose every 12 hours. The risk of side effects is likely to be substantial at that dose, though, and Cipro side effects can be a big deal. Flagyl gel is probably worthless.

Think hard about what you’re trying to accomplish with your treatments. Are you trying to relieve pain? Prevent enlargement? Prevent fistula formation? You’re less likely to do yourself harm if your temporary measures are purposeful, even though the tools available to you are *very* limited.

If there’s an ongoing leak creating an abscess then external measures tend not to work very well. Hopefully the source of infection is no longer a consideration.

Consider calling the CR surgeon’s office. Heck, if he’s taking calls over the weekend you might have a better shot at getting a call back from him today than tomorrow. Just ask him (or his office staff) for guidance about what to do until he can see you. If you’re able to make contact you’ll get better advice from him than from any of us, and he just might make your appointment higher priority.

Last edited by Scott F

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