About 3 months ago I had an abcsess lanced and left open to drain. It was right inside the sphincter. My surgeon made a cut from inside my rectal cuff all the way to the outside which is pretty much creating a man made fissure for the abcsess to drain. Well 3 months later I am still getting blood and pain from this area and it doesn't seem to be healing up. I am thinking that bowel movements keep this man made fissure from closing. The pain also causes spasms and throbbing in the muscles down there and creates a vicious cycle I think because the spasms just keep the incision open. Is it normal for something like this to take so long to heal? It almost makes me feel like I have UC again in the rectal cuff because it get so sore from the spasms and the wound. It's mentally and physically draining me! I take sitz baths which help temporarily but I can only do those early morning and night since I work in the oilfield. Is there anything else I could do to help calm things down or is this something that I should be concerned about? I am also finding it hard to hold in my bowel movement for very long as it is so painful and feels urgent.
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Are you sure there was not a fistula associated with this abscess? Because it sure sounds like you had a fistulotomy. Fecal incontinence is fairly common after this procedure while it heals, because part of the sphincter is divided.
http://www.fascrs.org/patients...xpanded_information/
Three months seems like a long time for you to be stuck at this phase, although it can take a very long time for complete healing. I agree that the spasms are counter productive, because they reduce the blood supply and delay healing. It is counter intuitive, but the passage of stool usually does not prevent healing, as long as they are not hard, constipated stools, or very caustic, watery stools. Fiber supplements may help in that regard.
Have you been given any topical anesthetics or ointments specific for fissure healing, such as nifedipine or dilitiazem? Those might help move things along.
When was the last time you saw your surgeon? If it has been a while, probably time for a recheck.
Sounds pretty rough to deal with. I hope you get some answers.
Jan
http://www.fascrs.org/patients...xpanded_information/
Three months seems like a long time for you to be stuck at this phase, although it can take a very long time for complete healing. I agree that the spasms are counter productive, because they reduce the blood supply and delay healing. It is counter intuitive, but the passage of stool usually does not prevent healing, as long as they are not hard, constipated stools, or very caustic, watery stools. Fiber supplements may help in that regard.
Have you been given any topical anesthetics or ointments specific for fissure healing, such as nifedipine or dilitiazem? Those might help move things along.
When was the last time you saw your surgeon? If it has been a while, probably time for a recheck.
Sounds pretty rough to deal with. I hope you get some answers.
Jan
Jan yes there was a fistula associated with the abcess that he said he "filleted" open. I'm not having continence problems just urgency and pain when its time to go. I tried thickening things up but it makes it difficult to empty because everything is feeling swollen down there. I agree I probably should get a check up but money is a little tight right now and I am on a 19 day straight stretch at work. He did give me a nitroglycerine compound after the surgery to help promote bloodflow and relax the muscles. I don't use it often though because of the terrible headaches that are associated with it. I have been thinking about asking for an oral anti-spasm medication. My surgeon is 6 hrs away though and generally doesn't prescribe meds without an office visit.
Nifedipine and dilitiazem work in a similar manner as nitroglycerine (NTG), but with less incidence of headache. Oral antispasmodic may or may not help, particularly if the blood supply is weakened down there. Somebody here was prescribed Neurontin (gabapentin) for sphincter spasms, and it was providing some decent relief.
Any chance of seeing your local GI until you can get to your surgeon? 6 hours is a long haul, even if you have the time and money for it! He could order medications for you.
In the meantime, you can use OTC hemorrhoidal creams to help as a local anesthetic. They may not work, but they will not hurt either. With it being a fistula, these can be quite stubborn to heal.
Jan
Any chance of seeing your local GI until you can get to your surgeon? 6 hours is a long haul, even if you have the time and money for it! He could order medications for you.
In the meantime, you can use OTC hemorrhoidal creams to help as a local anesthetic. They may not work, but they will not hurt either. With it being a fistula, these can be quite stubborn to heal.
Jan
6 hrs is definitely a long haul lol my GI is 2 hrs away... I guess there are downsides to living in the least populated state! Lol I think I will give the OTC cream a shot and maybe start using the nitroglycerin a little more. I willing to put up with a headache at this point if it means healing faster. I was also wondering if adding Epsom salts to my sitz bath would help? I have heard that Epsom salt contains healing and pain relief properties. Today seems to be going ok as far as pain goes but I haven't had to use the restroom much today either. The mornings are the worst for some reason and everything feels extra sore when I wake up. Not sure why that is but once I get to moving around then it calms down a little.
Epsom salts probably won't make a difference, but definitely wouldn't hurt. You never know. But, you'd have to get the bath water waaaay up there!
With the NTG, be sure to use a very tiny amount, as the dose does make a difference in regard to the headache.
Good luck!
Jan
With the NTG, be sure to use a very tiny amount, as the dose does make a difference in regard to the headache.
Good luck!
Jan
Ok thanks for all the help Jan!