No easing of pain. Could it be a perineal hernia? Would that show up on a CT?

Serious stuff should have shown up on the CT. That said, pain that is new is something to be investigated. Did your surgeon examine you (like do a digital exam and/or scope), or did he just look at he CT? You should be examined before you head out on a trip. Does it hurt more during a BM? If so, maybe there is a fissure, which probably ould not shw up on a CT. Did you have internal hemorrhoids before?

Call your surgeon again.

Jan

I am waiting to hear back from my surgeon - called earlier today. He did a DRE. The area doesn't hurt more with a bm but is uncomfortable after. I have had hemorrhoids with UC flares. Thanks for your response. It just doesn't seem right.

Maybe it just had not developed enough at the time he did the DRE (kind of like when you KNOW your kid has an ear infection, but if you go in too soon, there is nothing to see...).

If you had a fissure, the DRE would have stung quite a bit, I think. So, maybe more likely an hemorrhoid, since you have the history. But, still, it could be early signs of a perianal or perirectal abscess. You'd think the CT would show it, but they are not a perfect device, especially if something has not fully localized yet.

Jan

I the mean time I'd suggest you get an old fashioned blow up rubber donut to sit on. I bought one at a pharmacy. I found it worked better than the pillow or cushion ones. You can adjust the way you sit on it to achieve the most comfort. Sitting is hard enough after the surgeries with out your compliction. Take it on the plane, car, office, home - everywhere.
Good Luck!

Thanks for the suggestion. I'm in the hospital now for tests. They did another CT scan last night that showed inflammation. I'm waiting to hear what we do next. While waiting - no food or drinks. Should I be doing anything to reduce the bile/acid that happens when I don't eat?

You were right Jan, it is an abscess - after all the tests did not show it. When they biopsied the lump, the discharge confirmed abscess. So no flight, no return to work, very depressing. It has to drain. It could form a fistula. Do you have any advice for dealing with this? Any healing foods, should I be walking, what can I do to promote healing? I am to do sitz baths and there is pain medicine if I need it. Hopefully tomorrow I will be discharged. Jan, you are such a help to this site.

The number one, essential treatment for an abscess is drainage. And, drainage cannot occur until the abscess is fully localized and walled off as a pocket.

There is no "super food" or activity that hastens the process. Keeping it draining until the abscess pocket collapses and scars over is the only thing prevents the process from stalling. Antibiotics only serve to prevent extension of the infection. It is only the drainage that fixes it. Soaking with sitz baths helps keep it open and draining.

This takes time. Could be a month or more. If the pain returns, that is a sign that it healed over too soon and the abscess is reforming, so pay attention to it.

Good luck!

Jan

If you get into a cyclical "fill, hurt, burst, drain" cycle, start thinking fistula. I had an abscess form a fistula, started out as a sore bump, then it began to drain on its own. THEN it started this cycle where the skin would heal on its own, but the fistula was still there, so it would drain, then get walled off, start to form an abscess, but then burst and start all over.

Sitz baths are the best thing to do with them... they're soothing. You can also add Epsom salts to the water.

If that happens, confirmation can be done with a pelvic MRI. My fistula does not involve my pouch; it's low, and intrasphicteric only. I have a seton drain in, that stopped that "cycle" above, but it's just in there until the inflammation calms down. Probably will have it for a long time, at this time, but the longer I live with it, the easier it has become, but it's still annoying.

Got home from the hospital today - still have a low temp. They gave me flagyl to take. Should I take probiotics while taking this or after the 10 day course is done? Plenty of baths in my future. They said it could form a fistula and to watch for signs of one.

I continue to take probiotics while on antibiotics. I space them out so I'm not taking them anywhere near the same time. Pay attention to your body - some people get gassy on probiotics, for example.

I space taking probiotics 3-4 hours in between taking antibiotics. I hope your treatment plan works!

There was blood in the drainage overnight. I am worried that is a sign of a fistula. I finished the antibiotics on Tuesday. What do you think? Is this normal for abscess drainage this far out (2 weeks) or fistula. I'm scheduled to see the surgeon on Thursday.

I would not assume this is a sign of a fistula. I think this can be normal drainage. It can take weeks to months for an abscess to heal, and it can drain from time to time. That actually is a good thing for it to drain as needed.

Jab

My surgeon has now confirmed that I have a perianal fistula. It is the first time he has seen one with a j pouch. I am scheduled for a fistulotomy (lay open procedure) on Wednesday, the 11th. Could anyone share some details of your experience with this? How long for healing? What diet did you follow after the procedure? How did you manage the open incision with bathroom visits? I am worried about incontinence - has it affected your control at all? I work in live television and can't just run off to the rr. So any details and advice you could send my way would be greatly appreciated!