Can you explain why you have to have this done and what your symptoms are?

I have a fistula in my small intestines that is draining and filling an abscess in my lower abdomen, and a diseased part of my colon, they want to take out part of my colon, lower intestines and clean out the abscess…..I am worried because I've been feeling good since I've been on entyvio (6months) but the fistula doesn't seem to want to heal and continues to refill the abscess. From what I understand this won't stop until the fistula is healed or taken out. I would like the medicine to do its job and idk if surgery is the next step since it's only been 6 months I've been on it, I'm just overwhelmed with all that is going on.

Hello @lovablesteven and welcome to Mayo Connect.

I can certainly understand your concern about the possibility of surgery. Surgery tends to bring out the worst fears in us all, doesn't it?

Since you indicate that you have been feeling better on the Entyvio, have you sought a second opinion to determine if surgery is your only answer? If not, please seek out a second opinion from a GI specialist who specializes in this type of problem. It might be good to get your second opinion from a multidisciplinary medical team like a university medical center or a place like Mayo Clinic (Mayo has 3 locations in Minnesota, Florida, and Arizona).

Will you post again and update me on your progress?

Thank you for your reply, I haven been going over it with my GI doctor and he agrees with me about wanting to take my time and exhaust all other options first and hopefully seeing if entyvio will continue to work and do it's job. My one and only issue and concern is this abscess that I've had put a drain in and drained it, then it returned a week after the drain was taken out, my stomach feels fine after eating, bowel movements are good, pain is managed just this abscess that is causing me my one and only worries which is why I'm really second guessing the surgery.

@lovablesteven Your concerns are very understandable. Give yourself time for second opinions and thinking this through.

Here is a link that will take you to information about this type of surgery, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448907/.

While this article deals with this type of surgery for Chron's Disease the description of the surgery might be helpful to you. Did your doctor say if it would be an open surgery or a laparoscopic-assisted surgery?

Thank you again and The surgeon said it would be a laparoscopic surgery.

@lovablesteven Laparoscopic surgery generally has a quicker recovery time, so that would be a good thing.

As experience is very important, did he indicate how many of these procedures he has performed in the past?

Get as many opinions as you can. I agree with the other poster who suggested finding out all you can about the surgeon's and GI's experiences with your condition. Go to the best ones you can find. I had an emergency resection for a different reason, but from my experience, it has been a hard recovery and is life altering. Of course, you also don't want to wait until it's an emergency so it sounds like a delicate balance. Best of luck to you.

Dr Anna Serur is the Chief of colon and rectal surgeon in englewood hospital, she told me she does these kinds of procedures all the time and has two similar people getting it done this week and next..

Thank you guys for your comments it is greatly appreciated! I will do my research more I just wanted to give the meds enough time before I opt in to surgery

That sounds very good, @lovablesteven! I'm glad that you found out about her experience.

If it were me, I would feel more confident knowing about that.

Do you know if the ilocecal valve is going to be removed too?

Thank you yah I'm feeling a little less anxious day by day but I have my moments

Not to sure I did not ask her, is that something I should? What does the ilocecal valve do?

It's the sphincter muscle at the junction of the ileum (last portion of your small intestine) andthe colon, first portion of your large intestine. Its function is to allow digested food to pass from the small intestine to your large intestine. It acts as a barrier between the large and small intestine. It prevents the backflow of harmful toxins and bacteria overgrowth into the small intestine. It also prevents food from entering the large intestine before it's effectively digested.

For me, it's caused a real problem with SIBO ( small intestinal bacterial overgrowth) — the resection site (anastomosis) is wide open with no valve so there is no way to keep bacteria out of the small intestine. I do take an antibiotic daily callled Xifaxan which has made my daily life 100% better.
You might want to ask your dr about what the plan is regarding removal of the valve. I have to warn you, many GI's downplay the significance of the IV.