Dilation, Anoplasty, or both?
I'm a 54 year old man with inactive Crohn's disease. In 1983 I suffered terribly from extremely painful anal abscesses, fissures, and a fistula that tunneled its way to the surface of my buttock as a result of the disease. I had three surgeries including a fistulaectomy which left my buttock disfigured, my anus & rectum scarred, and even required my surgeon to cut the internal sphincter to resolve the problems. The resulting scarring from the surgery left me with pencil-sized stools and fecal leakage. The surgery substituted agonizing pain with disfigurement and the humiliation of dealing with my inability to stop soiling my underwear. A good swap in my opinion. I have happily dealt with those problems for over 20 years now.
Sometime after the surgery I became aware that my disease became quiet everytime I was put on Flagyl or other antibiotic for subsequent infections. Finally, after many years of 10mg of cortizone daily to control my disease, I demanded my doctor take me off the steroids and put me on a low dose of antibiotic for a short time to try to control the disease. He refused until I told him I would find a doctor who would. He finally agreed and put me on a daily low dose (250 mg) of erythromycine (which I believe is commonly used to control acne). Within six months my disease was completely quiet. My disease was finally in remission!! I stopped the antibiotic and I've been off all medication for close to ten years now. Hooray!!!
Earlier this summer I began to suffer from urgency again. This time, there was no diarhhea or bloody stool, but, instead, constipation with a great deal of pressure and an inability to distinguish my urinary sphincter from my bowel sphincter. I had a colonoscopy in June which showed no evidence of disease. But, my physician had to use a pediatric colonoscope because of a stricture that's formed. While the stricture was always there since the surgeries in '83, it was minor and never a problem. I could always easily evacuate and was never constipated. Also, the fecal leakage had worsened. And I've developed some small hemroids. My doctor suggested I try Rowasa for two weeks, but he & I are both relatively sure I will need surgery to fix my problems.
I meet with a surgeon next week to discuss my options. I am relatively certain that dilation is in my future. However, I need to stop the fecal leakage. It's become a real problem. Previously, a small wad of strategically placed toilet paper would usually keep me clean. That is no longer the case. I believe I am a candidate for anoplasty.
Does anyone know what I am in for? How long is recovery? Will a colostomy be necessary? Will I lose sexual function? Having lived through the pain I did in '83, I am sure I can take the pain again of the surgery (or at least I hope I can). But, am I simply substituting one set of problems for another set?
If anyone has experience with anoplasty & rectal dilation, I'd appreciate your thoughts. Thanks to all in advance.