Fistulas can result from different diseases and conditions, but they tend to be commonly associated with Crohns disease.
Although it may take time for a fistula to heal, there are treatments available.
There are nonsurgical ways to heal a fistula, but fistula repair may require surgery.
Verywell / Laura Porter
This article discusses both surgical and nonsurgical ways to heal a fistula.
Verywell / Laura Porter
What Is a Fistula?
A channel that forms abnormally between two organs or an organ and the skin is called a fistula.
Fistulas can happen anywhere in the body, but they most commonly affect thedigestive system, or digestive tract.
About 12% of people with Crohns disease have a fistula at any given time.
Fistulas can be a special problem for women with Crohn’s disease when they affect the vagina.
Inflammation and Fistula Development
Crohns disease can cause inflammationin any part of the digestive tract.
Further, all the layers of the walls of the intestines can be affected.
Its thought that this inflammatory process may lead to the formation of fistulas.
The cells in the walls of the digestive tract are affected by the inflammation and will change.
Anabscess, which is a pocket of pus, may form.
That abscess can grow and the result can be an abnormal connection, a fistula, between two organs.
They can be classified in a few different ways.
One of the ways a fistula is classified is according to the location in the body.
This includes:
Another way fistulas can be classified is as either simple or complex.
Most fistulas associated with Crohns disease are classified as complex.
Complex fistulas may be more challenging to treat and heal.
Antibiotics may not be all thats needed to heal a fistula but may help in preventing future complications.
Biologics:Biologic medicationscan help in reducing the inflammation triggered by Crohns disease.
This class of drugs may also help in healing a fistula.
If there are abscesses, those may need to be treated with antibiotics before a biologic can be used.
These drugs may work better in the case of uncomplicated fistulas.
In that case, enteral nutrition or intravenous nutrition might be used.
Surgery
Surgery is sometimes needed to treat a fistula.
Surgery may be used along with medical therapy to heal a fistula.
If there are abscesses, those are usually drained or treated with antibiotics prior to having surgery.
Surgery includes:
Seeing a Specialist
Fistula repair is complicated and requires care from a specialist.
Unfortunately, some fistulas are difficult to heal and there is a possibility that they may return.
Fistula repair will be done by acolorectal surgeon.
There may be other healthcare professionals involved as well, including a surgical nurse or gastrointestinal nurse.
Asitz bath(sitting in a shallow pan of water) may be recommended in some cases.
Stool softeners could also be part of recovery to prevent hard bowel movements.
Wound care instructions will be given by a surgeon or a nurse.
Surgical treatments arent without risks.
There could be discomfort or pain during bowel movements.
Feeling Secure
Being diagnosed with a fistula is challenging.
It can be embarrassing to discuss, especially when the fistula involves the anal area or the vagina.
It may help to work with a mental health professional to work through the emotions involved.
Having fears regarding a fistula and its treatment is expected.
An ostomy or wound care nurse will be a good resource in learning how to manage a fistula.
There are surgical and nonsurgical options for treating fistulas.
Which is right for you will depend on the location of the fistula and the complexity of treatment.
After treatment, constipation must be avoided.
A Word From Verywell
Having a fistula is inconvenient, uncomfortable, and embarrassing.
It is necessary to get it treated, however, so you can avoid more serious complications.
There are some choices to make regarding treatment options.
Understanding the potential effects may take time and asking a lot of questions.
Most people will need to take some time off work or school, at least a week or more.
The surgeon will have more instructions around recovery, but its possible it could take several weeks of self-care.
Fistula surgery is complex and requires a week or more of aftercare.
In some cases, there might not be any pain or discomfort with a fistula.
In others, there could be an abscess that causes pain, burning, or fever.
A fistula that involves the vagina may mean lots of drainage.
In some cases, surgery might only be covered if it is complicated.
You should talk to your healthcare team and an insurance carrier representative to learn what will be covered.
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