Anal Fistula Procedures

Posted by BILL T @billt, Aug 29, 2011

I HAD AN ABCESS IT WAS REMOVED AND NOW 14 MONTHS LATER I HAVE A FISTULA ON BUTTOX DRAINING. IF IT STOPS DRAINING I GET VER SICK. I MUST KEEP IT OPEN VERY PAINFUL.

DOCTORS SAY OPERATION TOO MANY COMPLICATIONS.

I KNOW THERE ARE OTHER PROCEDURES AND SURGEONS, BUT HAVE NOT FOUND THEM.

PLEASE HELP

COLON RECTAL SURGERY

I am 46yrs old and I have been suffering from “Fistulas” I have been to wound clinic and several Doctors and I am not fixed yet! I am so depressed from this please someone I need help to cure. I have had surgery on them, the Doctor closed them with surgical glue, and it created more and more! Some tunnel to the other one. I am misserable I get sick, fatigue and cold from them. I have like 6 now! One Doctor even put a colostomy in me and won’t remove it now! I need Professional Help! On top of all this I have Muscula Dystrophy and I have had my thyroid removed! I have almost died. PLEASE I’m begging for HELP!!! (Sad in Vancouver,Wa)

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@wendyailshie

I am 46yrs old and I have been suffering from “Fistulas” I have been to wound clinic and several Doctors and I am not fixed yet! I am so depressed from this please someone I need help to cure. I have had surgery on them, the Doctor closed them with surgical glue, and it created more and more! Some tunnel to the other one. I am misserable I get sick, fatigue and cold from them. I have like 6 now! One Doctor even put a colostomy in me and won’t remove it now! I need Professional Help! On top of all this I have Muscula Dystrophy and I have had my thyroid removed! I have almost died. PLEASE I’m begging for HELP!!! (Sad in Vancouver,Wa)

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You are not going to die, I have similar problem for more than 16 yeears now, am 35yrs old,have series of surgery without succees, also looking for the best way out. Am believing God for that soon.With my faith in Jesus Christ, i dont experience most of the discomfort i use to have about 10yrs ago, since i accepted Christ as my Lord and personal Saviour.Just draw closs to God, I kwow that one day it will be well with us.

Liked by Darlia

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Would like to hear from people who has or gone through this awful illness.

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@angiejimez

Would like to hear from people who has or gone through this awful illness.

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@angiejimez — hello, and welcome to Mayo Clinic Connect. Though this thread has been inactive for some time, I moved your post here in hopes some of its members might return and tell you a bit about their own experiences with anal fistula.

You may be interested in some of this information on anal fistula from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/anal-fistula/symptoms-causes/syc-20352871.

Some other Mayo Clinic Connect members who may have some thoughts for you on your fistula are @vdouglas, @dawn_giacabazi, @luv2float, @anon01345522, @hopeful33250 and @kanaazpereira.

If you feel comfortable, would you mind telling us more about when you were diagnosed and what types of symptoms you have been experiencing?

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I am a Mayo Connect member, publishing in Neuropathy most often. I also post in digestive health as I have Gastroparesis, IBS and GERD. I responded to a notification email on this latest subject here only to read about this ailment/condition. The reason I am drawn to it is because ironically yesterday and today, I have had blood on the tissue after a bowel movement. It’s more than a spot or two as I’d expect with the hemorrhoids but it is bright red not dark, so that leads me to think that it’s new and not from up in the colon.
Any suggestions welcome!
Just keep swimming, Just KEEP swimming!
Darlia

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@angiejimez

Would like to hear from people who has or gone through this awful illness.

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Hi
I had an perianal abscess in May 28- 2017 and had surgery to drain it. A fistula formed and in July 14 -2017 had a seton put on. Then in
October 20-2017, I had an advancement flap procedure done, but got very sick a week later. So, on November 2- 2017, the Dr. told me
that the procedure had failed and had to put a seton on again because I had another abscess starting. My doctor left town and referred me to another doctor, also a colon specialist, and he wants me to have surgery on February 9-2018 for an exam and to change the seton from silk to (I don’t know what), and that the original abscess had left me with a big hole or dent. Just wanted to hear from people that have gone thru this. I just don’t want to be going thru so many surgeries. According to my doctor, I do not have Crohn disease just had some real bad hemorrhoids that might have started the abscess, but these were removed on my July 14, 2017 surgery.
Would love to talk to people what it’s like. Thank you

Liked by Darlia

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@angiejimez

Would like to hear from people who has or gone through this awful illness.

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Hi Angie,

I have not had my issues that I described in my post yesterday for very long. The hemorrhoids though I have had for many years but now they are much bigger. I have them inside and outside. My last colonoscopy was in Nov. ’16 and they did find a polyp in the anal area of the colon and removed it. It came back as benign so then my Gastroenterologist and also my newest gastro dr as well, both said I don’t need to have another colonoscopy for 10 yrs because it was benign. Now the over the last 6 mnths or so I have had on and off bleeding. Yesterday evening though was the worst yet as it was much more blood than past times when it was just a couple of spots on the tissue. It happened after a colon call. (that’s what we call it in my household. lol) and it had been a normal bowel movement. Not constipated, actually a little loose but not diarrhea. I do have some cramping pain sometimes afterward, but I always attribute this to the IBS. I have not ever been diagnosed with Crohn’s or anything like that. I do have tortuous colon and also diverticulosis (not ‘itis’ which is the actual inflammatory flareup). So I am gathering as much info as I can through this Mayo connect so that when I tell my gastroenterologist, I can include what I have info about.
Darlia

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Thanks so much @darlia! Welcome @angiejimez! I’m sorry to hear about your symptoms, and so glad that you’ve joined this group.

Although not specifically about anal fistula, I sincerely encourage you to go through these past discussions about anal fissure and/or anal abscess:
https://connect.mayoclinic.org/discussion/chronic-non-healing-wounds/
https://connect.mayoclinic.org/discussion/pelvic-floor-dysfunction-with-constipation-in-males/
I’m also tagging @hew and @arieon69 with the hope that they will return to share their experiences with you.

Knowing the complete path of an anal fistula is important for effective treatment. Here’s some information about Mayo Clinic’s approach to treating anal fistula: https://www.mayoclinic.org/diseases-conditions/anal-fistula/care-at-mayo-clinic/mac-20352874

@angiejimez, I can imagine your reluctance to go through repeated surgeries; have you considered getting a second opinion?

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@kanaazpereira

Thanks so much @darlia! Welcome @angiejimez! I’m sorry to hear about your symptoms, and so glad that you’ve joined this group.

Although not specifically about anal fistula, I sincerely encourage you to go through these past discussions about anal fissure and/or anal abscess:
https://connect.mayoclinic.org/discussion/chronic-non-healing-wounds/
https://connect.mayoclinic.org/discussion/pelvic-floor-dysfunction-with-constipation-in-males/
I’m also tagging @hew and @arieon69 with the hope that they will return to share their experiences with you.

Knowing the complete path of an anal fistula is important for effective treatment. Here’s some information about Mayo Clinic’s approach to treating anal fistula: https://www.mayoclinic.org/diseases-conditions/anal-fistula/care-at-mayo-clinic/mac-20352874

@angiejimez, I can imagine your reluctance to go through repeated surgeries; have you considered getting a second opinion?

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The surgeries can be an extremely terrifying experience,
trust me I've had plenty and am only 27. As far as dealing with
recurring abscesses and such, may I ask your ethnicity? Here is why I
ask, a skin condition known as hidradenitis is very rarely diagnosed or
in my experience, it took my adult life for someone to tell me. It is
predominate in African Americans but does largely affect others as well.
What will happen is you'll be fine for a while, then boom! Here's an
abscess. It can start at any age. I believe that's what you may have
going on. But I'm not a doctor, just someone who has been through a lot
and knows a little bit about things. For me I was very young and it
started under my armpits and then as I grew older moved to my pelvic
area. So basically anywhere that's warm and accumulates moisture. Oral
antibiotics never seemed to work for me and several hospital admissions
followed. I was given Zyvox after a surgery and it destroyed my white
blood cells. I was ill for a week. Had to go back and stay close to
another month.

I believe the worst thing to do is to make a
gaping hole and not pack it while it closes or stitch it such because
it leaves room for anything, especially staph, to blossom. One thing you
can do is fill it with Manuka honey. It's a little expensive, but it
was amazing with my healing. And if you didn't know, bacteria can not
grow in honey. Also look into a wound vac, any wound center should be
able to set you up on a path for that. That can be a total game changer.
Also feel free to tag me again, it is a very difficult and depressing
thing to deal with, but always make sure to live your best life despite
the cards you were dealt.

Peace and Blessings,
Arieon

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Thank you so much for responding to my tag, and and sharing your experience, @arieon69! We sincerely appreciate it. And I’m sure @angiejimez will appreciate it too.

You mentioned hidradenitis, and I thought you may want to join this conversation about Hidradenitis suppurativa in the Skin Health group on Connect:
https://connect.mayoclinic.org/discussion/hidradenitis-suppurativa/

@arieon69, may I ask if any other family members have or had this condition? Could you share a few details about wound vac therapy?

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@kanaazpereira

Thank you so much for responding to my tag, and and sharing your experience, @arieon69! We sincerely appreciate it. And I’m sure @angiejimez will appreciate it too.

You mentioned hidradenitis, and I thought you may want to join this conversation about Hidradenitis suppurativa in the Skin Health group on Connect:
https://connect.mayoclinic.org/discussion/hidradenitis-suppurativa/

@arieon69, may I ask if any other family members have or had this condition? Could you share a few details about wound vac therapy?

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As far as my family goes, it use to be a frequent thing for my grandmother, my mother would get them far and in between, sisters was just about the same. It was just when it hit me, I don't know if it was because of diet or what because younger me, 10-12 me, ate poorly. But the older I got my diet changed (sort of) the introduction of Crohn's Disease caused me to drop about 40lbs over 3 months. The things I use to love all tasted weird lol.

Wound Vac therapy is amazing. It worked for me, as much as it could. My body… is just a special kind of subject. So what they do is cut and place a foam like substance over the wound, not in it. Then there is a film to keep the it down and provide the vacuum. The wound vac is connected to the film and once you cut it on, it starts the suction. It can be a little uncomfortable but trust me when I say, if you have a hole or chronic non-healing wounds, it will bring it up to the surface. From there, you just have to dress it with whatever your doctor recommends. I here silver is still a go-to for some. It's silver something, can't think of it, someone may have to chime to help you with that. But once its level, I don't doubt a good bandage or gauze to do the trick. Thats how flush it'll get it.

To start using wound vac therapy, I had to be referred through a wound care clinic. Some can actually do it there. You have to get it changed every 3 days or so and it will stink. But the end result is worth it. They'll measure the depth every time you visit, which can be uncomfortable. But it works.

Peace and Blessings,
Shay

Virus-free. http://www.avg.com

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I am a 44 Year old female. I developed my first fistulas about 5 years ago. It came about when I went to the ER with rectal pain (plus heart pounding and feeling like I was going to pass out) – the pain had been coming on but became unbearable that day. The ER doc didn’t believe anything was wrong until we demanded they do some sort of diagnostic imaging. They did an ultrasound of my rectal area and saw fluid. They sent me home but said the “best” colorectal surgeon would see me the next day. Without any further imaging, he took me in for surgery the following day. He found a fistula and put a seton in. Again, I still had pain and felt I was going to pass out. He sent me for an MRI, which showed a horseshoe shaped body of fluid, essentially between my rectum and tailbone. I ended up with 2 more setons for a total of 3 setons in place until my colorectal surgeon decided they were ready for removal. He said he would use one of three techniques to close the fistulas but when I came out of surgery, he said he did “nothing”. I was so happy to be done with the horrible ordeal, I didn’t question it. Because I always have loose stools, he said I have IBS but all he recommended was a colonoscopy, which showed nothing. No Crohn’s. I was already gluten free and wasn’t lactose intolerant but I tried the FODMAP diet on my own, with no change. They determined the IBS was stress, which I attempted to manage. I also noticed my IBS flared with my menstrual cycle. Once the setons were removed, I quickly started feeling pain, which felt like a fissure or another fistula. Then I felt a small lump. I went back to see the doc several times but they always said it didn’t “feel” like another fistula and could be scar tissue. The lump would be more inflamed with my menstrual cycle, so I mentioned that and they told me to go to a OBGYN, who said they believed it was related to the rectal issues and sent me back to the colorectal doc. In the meantime, I did multiple rectal and pelvic floor physical therapy treatments, which didn’t resolve anything. I finally got firm and told the colorectal doc that I knew my body and that I was sure I had another fistula and he reluctantly agreed to send me for an MRI, which proved I was right – it was a fistula. The fistula had also grown an abscess into my glute. My doc did not call me about the results, so I called him and he said “I don’t need to do anything”, so I asked for a referral. The process of finding another surgeon who accepted my insurance and then getting an appointment took 2 months and my primary care doc put me on 3 rounds of cipro and flagyl to keep the abscess under control, until I could see the new doc. The abscess burst. It was horrifying. My primary care doc called the first surgeon and he took me in for surgery a couple of days later. He found the fistula in that first surgery but he did not find or look for the communication between the fistula and the abscess and things were not healing. He took me in for another surgery, in which he cleaned out the small orange sized abscess and left me with a giant gaping hole in my glute. At some point, a new surgeon took over my case. She took me in for my 7th surgery and found the communication between the fistula and abscess and put a seton through that communication and cleaned out the abscess and my pain went from a 7-9 out of 10 every day, to hardly any pain, the majority of the time (I still have pain and inflammation flare ups). She took me in for an 8th surgery to replace my seton bands and probe the abscess but found it to be only 1/4 of the way healed. At this rate it will take a year to heal. She ordered an MRI which now shows two more fistula. Her current recommendation is to see a different surgeon who can do the muscle flap surgery but that surgeon won’t do the surgery without first doing an ostomy, which is devastating to me – I don’t know if I can do that. The other part of the plan is to see a gastroenterologist, to figure out the IBS and rule out Crohn’s/perianal Chrohn’s and see what is causing these fistula – I believe this should have been suggested long ago. I have read about stem cell therapy and hyperbaric being options before ostomy and I have asked my doc to look into that. I’m posting this in hopes that it first of all lets someone know they are not alone in how horrible it is to deal with complicated fistula. Secondarily, if anyone has advice or resources please let me know.

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@ashleyl

I am a 44 Year old female. I developed my first fistulas about 5 years ago. It came about when I went to the ER with rectal pain (plus heart pounding and feeling like I was going to pass out) – the pain had been coming on but became unbearable that day. The ER doc didn’t believe anything was wrong until we demanded they do some sort of diagnostic imaging. They did an ultrasound of my rectal area and saw fluid. They sent me home but said the “best” colorectal surgeon would see me the next day. Without any further imaging, he took me in for surgery the following day. He found a fistula and put a seton in. Again, I still had pain and felt I was going to pass out. He sent me for an MRI, which showed a horseshoe shaped body of fluid, essentially between my rectum and tailbone. I ended up with 2 more setons for a total of 3 setons in place until my colorectal surgeon decided they were ready for removal. He said he would use one of three techniques to close the fistulas but when I came out of surgery, he said he did “nothing”. I was so happy to be done with the horrible ordeal, I didn’t question it. Because I always have loose stools, he said I have IBS but all he recommended was a colonoscopy, which showed nothing. No Crohn’s. I was already gluten free and wasn’t lactose intolerant but I tried the FODMAP diet on my own, with no change. They determined the IBS was stress, which I attempted to manage. I also noticed my IBS flared with my menstrual cycle. Once the setons were removed, I quickly started feeling pain, which felt like a fissure or another fistula. Then I felt a small lump. I went back to see the doc several times but they always said it didn’t “feel” like another fistula and could be scar tissue. The lump would be more inflamed with my menstrual cycle, so I mentioned that and they told me to go to a OBGYN, who said they believed it was related to the rectal issues and sent me back to the colorectal doc. In the meantime, I did multiple rectal and pelvic floor physical therapy treatments, which didn’t resolve anything. I finally got firm and told the colorectal doc that I knew my body and that I was sure I had another fistula and he reluctantly agreed to send me for an MRI, which proved I was right – it was a fistula. The fistula had also grown an abscess into my glute. My doc did not call me about the results, so I called him and he said “I don’t need to do anything”, so I asked for a referral. The process of finding another surgeon who accepted my insurance and then getting an appointment took 2 months and my primary care doc put me on 3 rounds of cipro and flagyl to keep the abscess under control, until I could see the new doc. The abscess burst. It was horrifying. My primary care doc called the first surgeon and he took me in for surgery a couple of days later. He found the fistula in that first surgery but he did not find or look for the communication between the fistula and the abscess and things were not healing. He took me in for another surgery, in which he cleaned out the small orange sized abscess and left me with a giant gaping hole in my glute. At some point, a new surgeon took over my case. She took me in for my 7th surgery and found the communication between the fistula and abscess and put a seton through that communication and cleaned out the abscess and my pain went from a 7-9 out of 10 every day, to hardly any pain, the majority of the time (I still have pain and inflammation flare ups). She took me in for an 8th surgery to replace my seton bands and probe the abscess but found it to be only 1/4 of the way healed. At this rate it will take a year to heal. She ordered an MRI which now shows two more fistula. Her current recommendation is to see a different surgeon who can do the muscle flap surgery but that surgeon won’t do the surgery without first doing an ostomy, which is devastating to me – I don’t know if I can do that. The other part of the plan is to see a gastroenterologist, to figure out the IBS and rule out Crohn’s/perianal Chrohn’s and see what is causing these fistula – I believe this should have been suggested long ago. I have read about stem cell therapy and hyperbaric being options before ostomy and I have asked my doc to look into that. I’m posting this in hopes that it first of all lets someone know they are not alone in how horrible it is to deal with complicated fistula. Secondarily, if anyone has advice or resources please let me know.

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@ashleyl honestly I don't know how you have managed all you have been through. I thought my gastro issues were bad. Mine are a breeze compared with what you have been through. My advice, and this comes from my experience with local doctors, get yourself to Mayo Clinic! I have not even close to the issues you do and I got very fed up, saw a gastroenterologist at Mayo a month ago and have answers. Should have done this 5 years ago, would have saved myself many tears. I am serious, I found a wonderful doctor and it was so worth it. Stayed at a great hotel with free shuttle service, as most do in Rochester, so many friendly helpful people who actually know what they are doing! Call Mayo!

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@ashleyl

I am a 44 Year old female. I developed my first fistulas about 5 years ago. It came about when I went to the ER with rectal pain (plus heart pounding and feeling like I was going to pass out) – the pain had been coming on but became unbearable that day. The ER doc didn’t believe anything was wrong until we demanded they do some sort of diagnostic imaging. They did an ultrasound of my rectal area and saw fluid. They sent me home but said the “best” colorectal surgeon would see me the next day. Without any further imaging, he took me in for surgery the following day. He found a fistula and put a seton in. Again, I still had pain and felt I was going to pass out. He sent me for an MRI, which showed a horseshoe shaped body of fluid, essentially between my rectum and tailbone. I ended up with 2 more setons for a total of 3 setons in place until my colorectal surgeon decided they were ready for removal. He said he would use one of three techniques to close the fistulas but when I came out of surgery, he said he did “nothing”. I was so happy to be done with the horrible ordeal, I didn’t question it. Because I always have loose stools, he said I have IBS but all he recommended was a colonoscopy, which showed nothing. No Crohn’s. I was already gluten free and wasn’t lactose intolerant but I tried the FODMAP diet on my own, with no change. They determined the IBS was stress, which I attempted to manage. I also noticed my IBS flared with my menstrual cycle. Once the setons were removed, I quickly started feeling pain, which felt like a fissure or another fistula. Then I felt a small lump. I went back to see the doc several times but they always said it didn’t “feel” like another fistula and could be scar tissue. The lump would be more inflamed with my menstrual cycle, so I mentioned that and they told me to go to a OBGYN, who said they believed it was related to the rectal issues and sent me back to the colorectal doc. In the meantime, I did multiple rectal and pelvic floor physical therapy treatments, which didn’t resolve anything. I finally got firm and told the colorectal doc that I knew my body and that I was sure I had another fistula and he reluctantly agreed to send me for an MRI, which proved I was right – it was a fistula. The fistula had also grown an abscess into my glute. My doc did not call me about the results, so I called him and he said “I don’t need to do anything”, so I asked for a referral. The process of finding another surgeon who accepted my insurance and then getting an appointment took 2 months and my primary care doc put me on 3 rounds of cipro and flagyl to keep the abscess under control, until I could see the new doc. The abscess burst. It was horrifying. My primary care doc called the first surgeon and he took me in for surgery a couple of days later. He found the fistula in that first surgery but he did not find or look for the communication between the fistula and the abscess and things were not healing. He took me in for another surgery, in which he cleaned out the small orange sized abscess and left me with a giant gaping hole in my glute. At some point, a new surgeon took over my case. She took me in for my 7th surgery and found the communication between the fistula and abscess and put a seton through that communication and cleaned out the abscess and my pain went from a 7-9 out of 10 every day, to hardly any pain, the majority of the time (I still have pain and inflammation flare ups). She took me in for an 8th surgery to replace my seton bands and probe the abscess but found it to be only 1/4 of the way healed. At this rate it will take a year to heal. She ordered an MRI which now shows two more fistula. Her current recommendation is to see a different surgeon who can do the muscle flap surgery but that surgeon won’t do the surgery without first doing an ostomy, which is devastating to me – I don’t know if I can do that. The other part of the plan is to see a gastroenterologist, to figure out the IBS and rule out Crohn’s/perianal Chrohn’s and see what is causing these fistula – I believe this should have been suggested long ago. I have read about stem cell therapy and hyperbaric being options before ostomy and I have asked my doc to look into that. I’m posting this in hopes that it first of all lets someone know they are not alone in how horrible it is to deal with complicated fistula. Secondarily, if anyone has advice or resources please let me know.

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Hello @ashleyl and welcome to Mayo Connect,

I've read your post and feel so badly for all of the procedures you have been through and know that you still have pain. I hope that some other members of this discussion group will post and provide some of their experience as well as suggestions. In the meantime, I did some research on Mayo Clinic's website. This provides information on how Mayo doctors approach this type of disorder. Please take a look at this article and see how many of the tests and procedures you have had.
https://www.mayoclinic.org/diseases-conditions/anal-fistula/care-at-mayo-clinic/mac-20352874
I would encourage you to seek a second or even third opinion to see what else can be done. Do you live near a Mayo facility or near a university medical school? This might be a good way to get a reliable second or third opinion. If you would like to be seen at one of the 3 Mayo facilities here is information as to how to get an appointment with a Mayo specialist, http://mayocl.in/1mtmR63.

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Hello:

I’m sorry to hear you’re in such pain.

My son had an anal fistula. They are horrible. We went to a colorectal clinic. The doctor did a fistulotomy as soon as he saw it. I didn’t know he was doing it and when I saw the wound I almost fainted! It was a huge open wound. It did work though, the pain was gone.
The doctor just told me that the wound must heal from the inside out. So “mother” you have to clean this twice a day. I did!
First I had to clean it with hydrogen peroxide and make sure the wound was not closing AT ALL! Once it was clean I was to put corn starch in the wound. We did this every single day for months. My family doctor said he could have nurses come in to the house but by then I was already doing it and, to be honest I thought I could do it better 🙂
This may be an old fashioned way of dealing with a fistula but it worked for us, that was about twenty years ago. No reoccurrence.
It was time consuming and a bit of a
pain to be honest but it worked.
It’s fine when you are young and have a
mom to help you but probably not feasible for a lot if folks.
I just thought I’d share my experience in case it helps in any way. Packing wounds and drains are good but it so easy to reinfect. Keeping them open and pristine works but, again, not easy to do and impossible to do on your own.
I really hope you get the help you need and can get to a doctor at he Mayo Clinic.

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