I have received no medical training; I am not a medical professional. The following is not medical advice. You should ALWAYS check with your physician before making any changes to your diet, lifestyle, or medications. If you feel you have a real medical emergency, you should seek immediate medical attention by calling your doctor or dial 9-1-1.
The following is intended for mature readers only. Not recommended for children or those who may have a weak stomach. Reader discernment advised.
The decision was made to begin releasing as much of my medical records relevant to Crohn’s disease (CD) in an attempt to help others who may be going through something similar. Only by sharing information on any medication condition/disease/illness, we can add to the collective knowledge while simultaneously increasing awareness of the brutality of the disease discussed in this article, inflammatory bowel disease, more specifically, Crohn’s disease (CD).
The names my surgeons have used to describe this manifestation of Crohn’s disease are “anal Crohn’s disease” (ACD), “anorectal Crohn’s disease” (ACD), and “perianal Crohn’s disease” (PCD), although there are many names used. Such as “fistulizing Crohn’s disease.” No matter what you choose to call it, this manifestation of CD is pretty much anything but glamorous. Hence the “content advisory warning” at the top of the page.
Anorectal/Perianal Crohn’s disease (ACD)/(PCD)
Two years after being diagnosed with CD, in July 2007, I was diagnosed and treated for my first anorectal “complication.” I have had about 20 surgical procedures since. The treatment for which is almost always surgery.
An anorectal/perianal abscess, as defined by med, is. “an infection that affects one of the glands around the anus. The gland gets blocked and then gets infected. The tissue around i/t acutely inflamed and becomes very painful.” The treatment for which is almost always surgery.
Below, I’ve listed most of the surgical history associated with Crohn’s since my diagnosis. Fever, chills, pain/swelling/inflammation usually characterize the condition. However, patients do not always present with these symptoms. I don’t recall ever running a fever, in all of the nineteen plus instances. If you have any of the above symptoms, consult your doctor, or seek immediate medical treatment.
‘Surgical History pt. I: A Brief Overview’
I.) See the “Key” at the bottom of this list. You will find translations or links to translations for some of the medical terminology used in the notes made by my surgeons, which I copied directly from my medical history.
1. Small bowel resection with partial small bowel removal also known as (ileostomy or ileocolic resection) — [01/??/2005]
2.) Anorectal *EUA (examination under anesthesia), *unroofing of subcutaneous fistulas (x2) and delineation of complex fistulas with placement of draining, noncutting setons — [07/09/2007]
3.) I&D (incision and drainage) large R ischiorectal abscess — [01/28/2008]
4.) Unroofing with debridement and drainage of abscess cavities — [02/29/2008]
5.) Unroofing and debridement of multiple abscesses — [01/28/2009]
6.) I&D of L posterior superficial perianal abscess — [2/20/10]
7.) I&D anterior midline superficial perianal abscess — [7/8/2012]
8.) Disimpaction, rigid proctoscopy and I&D of L anterior perianal abscess — [10/25/2012] `
9.) Anorectal EUA I&D abscess drain placement — [5/24/14]
10.) Rigid proctoscopy, seton removal, placement of new draining, noncutting setons, I&D perineal abscess, and fecal dis-impaction — [03/31/2015]
11.) I&D perirectal abscess with placement of draining, noncutting seton — [5/30/15}
12.) Exploratory lap and ileocolectomy, bilateral taps block — [10/14/2015]
13.) Rigid proctoscopy with seton placement x2 — [10/14/15]
14.) Rectal EUA — [03/31/2016]
15.) Anal fistula w/ seton x2 — [08/29/2016]
16.) Rigid proctoscopy & seton placement — [11/03/2016]
17.) I&D abscess in office — [02/21/2017]
18.) Incision and drainage of ischiorectal abscess — [01/20/2018]
19.) Subcutaneous anal fistulotomy and seton placement. — [01/17/2019]
20.) Anal fistulotomy with seton placement. — [08/20/2019]
- Ileocolectomy – “A laparoscopic ileocolectomy is an operation that removes a diseased section of the ileum (last segment of the small bowel) and ascending colon.” – WebMD
- Anorectal EUA – (examination under anesthesia): “Examination of the perineum, digital rectal examination (DRE), and anoscopy are performed after the anesthesia of choice is administered. This must be done before surgical intervention is initiated, especially if outpatient evaluation causes discomfort or has not helped to delineate the course of the fistulous process.” – ‘Medscape’
- Unroofing of subcutaneous fistulae– “The technique involves the identification of the tract under anesthesia. A partial lay-open fistulotomy is performed by unroofing the lower portion of the fistula from the internal opening”. – MH Whiteford – 2007
- I&D (incision and drainage) -“When the abscess is perianal or superficial, drainage can usually be accomplished in the office or ED with local anesthesia. A small incision is made over the area of fluctuance; to shorten the length of any fistula that may form, the incision should be made as close to the anus as is compatible with safety. – Medscape
In part two, I’ll be going into more detail on this particular manifestation of CD. ∴
As always, thanks for reading,
– Jonathan L. McLendon