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Hi,

after my takedown in January, things were tough. 20 bm/day. Leaking sensations. Thickeners caused gas, but bowel showers, including tincture of opium, helped a little. My bottom got to hurting bad, but if thought it was butt burn, then hemerhoids. Turned out it was an abscess. When doc lanced it, he found it to be a fistula from anal cavity and gave me cipro & flagyl. WOW!  Suddenly abscess gone and pouch felt fantastic and bm dropped to just 4-5 day!  Wonderful!

 

after 10 day course of the antibiotics, things felt good for a month, but fistula 'bump' grew again and movements weren't quite as under control. 10 more days of cipro and a pouch scope. Doc says he saw 2 distinct ulcers in pouch and now, because of that and the fistula, thinks it could be crohns. He wanted to start me on Humira, and if fistula resolved, that would also diagnose it. Then he remembered I had been on remicade last year (for UC just prior to surgery, it didn't do the trick) and said for me to start remicade instead of Humira since we know i had no adverse reaction. 

 

Questions!  Anyone with similar experience/changed diagnosis?  Can't fistulas be just an affect of the surgeries and not necessarily crohns?  Two ulcers might just be pouchitis?  Is remicade a superior or inferior option to Humira for this matter?  Help, please!  Thank you!

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Hi
I'm not sure if this may help you or not. I have a lot of your symptoms, burning anal canal, pouch ulcers, frequent pouchitis, but have had my pouch for four years with no fistula sand hence no crohn's diagnosis.  I question this as I have a lot of the symptoms if peri anal crohns with discomfort   in my anal canal all the time. I am getting pouch scoped on 5:26 and can report back findings.  I often take cipro on and off for these issues.  Often it seems the fistula diagnosis and ulcers above the pouch lead to a crohn's diagnosis.

I'm no doctor but since your surgery is so recent I'm more inclined to think the fistula is a result from the surgery. Although I can't speak of the ulcers that were found. I had a fistula that resulted in a huge abscess after my first surgery. I was very fortunate that it healed quickly (within three months) and I was able to have my takedown surgery. I suppose time will tell for you....best wishes. 

Hi!  My son had his take down in September of 2014.  We are not sure exactly when, but sometime between then and Noember developed a huge fungal abscess and fistulia.  We know that the fistulia was connected to the pouch and that explained the abscess.  But like I said, it was fungal.  In December they put in a drain in his back to drain the abscess.  In January they found the fistulia and immediately but him on light bowel rest.  No food, just clear liquids by mouth and put him on TPN.  Introvenus feeding for 8 weeks.  The fistulia still did not clear up so in March 2015 they reversed him again and put him back on the colostomy.  Hopefully with complete bowel rest, the fistulia will clear up and they will do the takedown again.

 

good luck

 

dianne

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