Fistulas and Abscesses |
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As if dealing with the pain, fatigue, and diarrhea of Crohn’s wasn’t enough, there are more severe problems to worry about.
With the definitive factor of identifying Crohn’s from IBD being that the ulcers work their way through all of the layers of the intestines, it makes sense that the complications of Crohn’s should be so much more dangerous.
In particular, the formation of abscesses and fistulas can and do cause a great deal of concern for doctors and their patients alike.
Abscesses
An abscess is a pocket of infectious waste and pus. These can occur anywhere in the body at any time; however, they are considerably more common in Crohn’s patients than the general population due to the decrease in their immune system’s effectiveness.
Unlike an external abscess, those found inside the body, and in particular on the intestinal tract, cannot be simply sliced and left to drain. Doing this is tantamount to filling the body cavity with a noxious infection and waiting to see what would happen.
Instead, the abscess requires draining with a small catheter, or tube, that’s inserted into the blister and allowed to drain externally. This is typically done during a laparoscopic surgery, which is a minimally invasive surgery, involving only two small cuts: one for the insertion of the catheter and the other for a small camera to be inserted to allow the surgeon to see what he’s doing.
Once the abscess has drained and is on its way to healing, the catheter is removed and the tiny hole where the tube exited the body is closed with a butterfly bandage, or possibly one or two stitches, depending on where it is.
Fistulas
While abscesses cause extreme discomfort and are difficult to be addressed without surgery, they do not cause nearly the concern of fistulas.
As was stated, Crohn’s disease involved ulcers in the intestines that burn their way through all layers of the bowels. When this happens, the ulcer can also work its way through any other organs that happen to be near where it exits the guts.
Because the body is most interested in healing itself, once the inflammation is under control, it begins to rebuild the tissue where the ulcer had been. If two or more organs or other parts of the body are close to each other and had been affected by the ulcer, they can heal together causing a tunnel from one into the other. This tunnel is called a fistula.
The fistula can be created anywhere in the body cavity that the ulcer can reach. They can even create a channel from the intestines to the outside of the body if the ulcer should eat its way through the abdominal wall.
Though the use of such medications as infliximab has slowed down the need for surgery, that course is still most often used to correct the damage done by the ulcer. Because of the risk of infection during surgery, as well as the inherent risks, doctors do their best to prevent fistulas from forming through the use of anti-inflammatories and immunosuppressents to relieve the inflammation that causes the ulcers.
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