Adding fibers and cereal food to your diet will help to prevent constipation, which can irritate a fistula. Try noticing what types of food you are allergic to or that upset your stomach. Remember that it’s not always a stiff rule — each person is different. Fatty waste can increase the possibilities of blocking an anal fistula tunnel and thus can induce the formation of perianal abscess, the major cause of pain in people suffering from fistulas.
Excess water will make waste softer and will help clean the intestines; this is why if you drink excess amounts of water you will feel the need to enter the toilet more often. Water also prevents the intestines from getting blocked especially in patients suffering of some digestive diseases like Crohn’s disease, toxic megacolon, etc.
Do what you can to feel comfortable. Try to avoid situations where you can foresee being uncomfortable or bring a pillow or other aid with you.
Adult diapers work, too, they’re just a little bulkier and more stigmatized. Pads are thinner and much easier to deal with. Change the pads often as well since the discharge will have an unpleasant odor.
If you’re outside and can’t do this, always keep wipes with you to be used instead until you can get home. Your hands experience have the most exposure to germs and therefore must stay clean. Change your underwear as needed throughout the day if the fistula is leaking. Change towels each time you bathe, too. Both of these prevent the spread of germs and growth of bacteria which can reduce perianal irritation and thus will help in eliminating the annoying symptoms people with fistula suffer from.
Pain may be a complication of fistula. A blocked tunnel will fill up instead of draining pus out — a process that may lead to the formation of an abscess, or a sack of pus near the skin surface. Pain also can be accompanied with an irritating sensation and redness that looks similar to diaper rash around the perianal skin because of the pus draining.
Computerized Tomography (CT scan). Especially in patients with Crohn’s disease, a CT scan indicates the inflammatory stage before the possible formation of a fistula, in addition to showing the cavities of abscess to determine if surgical care is needed. Magnetic Resonance Imaging (MRI). This a helpful method to determine any enteric fistulas by revealing any inflammatory changes or accumulation of fluids in the fistula tube. Fistulography. This is an X-ray method in which a contrast media is injected at the external site of a fistula to clarify the fistula path and how deep it is through the tissues which will help in choosing the treatment. Ultrasonography. This combined with physical examination can be used to identify any presence of abscess or fluid accumulation that may reside in the fistula tube. Cystoscopy. This is useful for the “enterovesical fistula” that connects the intestine with the bladder. Microbiological tests. To indicate any sign of infection, especially in the presence of abscess, a urine culture may be required in case of colovesical fistulas.
In fistulotomy for rectal fistulas, a procedure called endorectal flap will be used. This is where the surrounding healthy tissues get put inside the fistula cavity to ensure the prevention of its blockage by feces in case of a recurrent infection. A seton stitch (passing a cord into the fistula in order to keep it closed during the drainage) is also reported to be used in fistulotomy. This, however, usually takes multiple visits to your doctor until recovery and eventually the stitches dissolve. There is a “Cutting Seton Treatment” known as “Kshar Sutra Therapy,” which has a high success rate.
Esophageal dilation. This may last for months or even years in some patients. Flexible-metal mesh stents. These are the most effective in maintaining esophageal patency and structure. Plastic coated mesh stents. These can also be used to occlude trachea-esophageal fistulas; some are powered with a valve that prevents reflux when the fistula is located near the esophageal sphincter.
There are other issues that are related directly to intestinal fistulas that the affected patient must follow up on and be aware of, too. They must avoid sepsis by treating any signs of infections, such as inflammations in the tissues surrounding the fistula, control the drainage of the fistula and keep good care of the skin to maintain the nearby tissues in a healthy state. A gastrostomy tube may be required to feed someone with an esophageal fistula. This goes in through the abdominal wall and directly into the stomach. If needed, the tube would be placed while the patient is under anesthesia so they will not be in pain. [14] X Trustworthy Source MedlinePlus Collection of medical information sourced from the US National Library of Medicine Go to source
Fistulas can be treated initially with a compound treatment of metronidazole and ciprofloxacin or vancomycin. Metronidazole will be 250-500mg every 8 hours; Vancomycin is 125-250 mg every 6 hours, or three times daily one hour after eating.
Recto-vaginal fistulas may be secondary to Crohn’s disease, obstetric injuries due to birth, radiation therapy or cancer. Fistulas in children or infants are mostly congenital affecting boys more than girls.
Constant discharge (pus) Pain (related to infection) Bleeding Pain in the abdomen Diarrhea Loss of appetite Weight loss Nausea and vomiting
Blind Fistula: A link between two surfaces; one end is closed and the other is opened. This can turn into a complete fistula if untreated. Incomplete Fistula: A link has only one external opening. Complete Fistula: A link between an internal opening and external opening. Horseshoe Fistula: A link in a U shape, between two external openings around the anus.
Secretions that produce inflammation around the anal area Tumors of the anal canal Radial fungus disease (very rare) Exposure to severe trauma Cracks around the anal area Infections of the digestive tract Because of this, it is highly advised that you clean the anus well after using the toilet, observe the rules of public safety and personal hygiene, and use wipes after using the toilet and throw away after each use.
