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Digestive Disorders

Crohn`s Disease

05/20/2008

Question:

I have a 27-year history of Crohn`s with two small bowel resections, iron-deficient anemia, and kidney stones. Disease was inactive for ten years. Recently, it returned in two areas (descending colon and rectum) that I never had previously. It caused two perianal abscesses that resulted in three fistulas. Three Setons are in place. The descending colon apparently has severe narrowing and there is a small area in the rectum that is diseased and afrible.

I recently had my second infusion of Remicade. The fistulas are still draining greenish pus but not as much that was happening pre-Remicade. I have one more infusion to go in four weeks. Three quick questions, please.

1. Is it normal that the fistulas continue to drain after two infusions? 2. I really would like the Setons removed after my third infusion when I see my colorectal surgeon again. Is that likely to happen? 3. If the fistulas close, are they then considered cured and this will not happen to me again?

Thanks for your help.

Answer:

It is common for drainage to continue for a while after Remicade is started. You surgeon may want to evaluate your rectum for resolution of inflammation before removing the Setons. Try to schedule an appointment shortly after your infusion to ask.

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati