Baby & Fistula's

[JodieB]

I have posted a similar question regarding Setons, but I'm new to this forum and didn't realize there was a strictly women board that we could ask questions in.

I am not pregnant and we are not trying for a baby yet, but I would like all the facts before we make any surgical decisions and I feel as though I don't have much time with continuous infections.

Has anyone had a baby with perianal fistulas with or without treatment? If so, what did you do? Would you recommend it to someone who has not officially been diagnosed with Crohns?
Suugestions? Ideas? Comments on the matter? I feel I am lacking information on making a decision of when to get pregnant considering we were planning on starting a family this year and have now been thrown this fistula curve ball.

-Jodie

 

[SarahBear]

Hi, Jodie!

I don't personally have any experience with either fistulas or pregnancy, so I'm afraid I won't be much help. I do have a few questions for you, though.

Do you have any other symptoms besides the fistulas? Does your treatment seem to be helping?

I see you posted in the Fistulas, etc. section as well. It looks like most of your questions have been answered over there. Do you feel more comfortable in the private Females section?

:hug:

 

[UnXmas]

Hi. I have no experience of this either, but remembered reading this when researching Crohn's recently:

Complications of Crohn's disease, such as bowel obstruction or ulcers, can be treated during pregnancy. Fistulas are common in people with Crohn's. These abnormal connections can occur between different parts of the intestine, between the intestine and skin, or between the intestine and other organs, such as the bladder and vagina. Also common are anal fissures — cracks or clefts in the anus or the surrounding skin. These complications are often of particular concern to pregnant women considering vaginal delivery.

If you have fistulas or fissures, a vaginal delivery may not be the best option, particularly if an episiotomy (which involves an incision of the tissue between the vagina and the anus) is required. If that incision does not heal properly, Crohn's symptoms in that area could become much worse. In this situation, Cesarean delivery (C-section) may be the better choice. But if you don't have fistulas or fissures in this area, vaginal delivery may be fine.

This is from the Mayo clinic, the whole page on pregnancy and Crohn's is here http://www.mayoclinic.org/medical-edge-newspaper-2009/jan-09b.html

Sorry it's not much to go on, but at least it seems you'll be able to manage pregnancy even with fistulas.

 

[LisaL]

Ugh...I had a peri-anal abscess, fissure and small fistula about 4 months ago. it was unbelievably painful!!

My GI doctor suggested I see a colo-rectal surgeon which I did. I was very embarrased and in a lot of pain, and thought I would cry while I sat in the exam room waiting me meet an complete stranger who was going to look at my butt. And, I was terrified that she would hurt me! I explained everything to her and she tried gently to see what was going on. She could see that a skin tag was very infected but knew that the whole area was too sensitive to examine any further. i was scheduled for an 'exam under anesthesia" the following day and while I was sedated she removed the skin tag, irrigated the infection and opened up the fistula it was shallow and not very complicated).

When it was over I felt no pain for a day or two while the area was still numb, and then some serious pain for another 4-6 days while things healed. It took longer than I would have wanted, but I did recover completely. I hope to NEVER have that experience again.

I would definitely talk with your GI doctor about seeing a colo-rectal surgeon. There is no reason to be that uncomfortable. Unless there are significant complications I don't think a peri-anal fistula should get in your way. The issue of episiotomy issue would be something to discuss with your OB.

Good luck!
Lisa

 

[Mama & Mac]

Hello Jodie
Happy to see you are on the forum, I have found someone out here will always see a post and have some answers of some kind.
I myself have had a daughter while dealing with 3 very large fistulas that remained untreated until her birth (the one main thing I was unable to have vaginal birth) my fistulas unfortunately turned into perianal / vaginal fistulas. After which I was treated with seton placement, then and ileostomy, my daughter is now 6 and I'm still dealing with this issue. I guess what I'm saying is that I had a child with the perianal disease and fistulas, and it didn't change my problem either way. As a mom I will say this if a baby is what you both really want don't let this stop you unless your doctor tells you otherwise.
Being a mom is pretty great!
I hope I have helped.

 

[JodieB]

Thanks for this insight Mama & Mac. It's such a crazy thing to be dealing with right when we were planning on starting a family. When I asked by colorectal surgeon about it she said that I can most definitely get pregnant now but the ways of treating the infection are limited.
It's such a confusing thing. Just trying to navigate what is best for me and if it's safe for a baby. I just don't want to wait too long before having a baby. We have wanted a big family for some time and this is putting a real damper on things. I really appreciate your insight on how it didn't make much of a difference for you - I'm happy that it didn't get worse.

 

[Mama & Mac]

I'm happy I could help Hun,
Also on that note, I had my little monkey when I was 37. Don't rush. You will know the right time for you, I also wanted a large family but it was not in the cards for me, but still very happy with only having one, and she is spoiled like crazy.
I wish you all the best.
Karrie

 

[Lisa]

I had active perianal/recto vaginal fistulas when I got pregnant (at 33).....the pregnancy itself was unremarkable, but I did have a c-section to avoid any issues with the fistulas. I didn't have any issues with that either, and when my daughter was 7 months old I was able to start Remicade, which took care of the fistulas!

 

[JodieB]

It's so nice to hear that people have had such success. I'm curious though pasobuff did you have any flare ups or infections during the pregnancy and if so how did they treat them? I'm having trouble going "infection" free.
Did your flare ups cause pain? If you dont mind, I'm curious what your symptoms are when your Fistulas would fill? Because we have a similar situation I would love to hear about yours. I'm feeling a little confused about what might be another infection or what may just just discomfort at my previous surgery sights?

 

[Lisa]

Hi Jodie - I was actually VERY healthy during my pregnancy...a little background, I had been in the hospital for a bad flare not long before I got pregnant.....so I had been on some pretty 'hard' meds to get the flare under control.....

As far ass treatment of the fistulas, there really wasn't any while I was pregnant - I had seen a colo-rectal surgeon before that, and the attitude had been to 'wait and see' as I wasn't dealing with infections.....

Mine were actually draining fistulas, once they actually 'popped' that is...and boy was that painful....so, when I was flaring, I would have active leakage etc...not fun.

My fistuals were almost always painful to some extent, especially if I was having other symptoms.

I did havemy daughter via c-section to avoid any complications from the fistulass tearing etc...that went very smoothly with no complications.

If you have any concerns, I'd recommend contacting your doctor to have a check done. Better safe than sorry!