Firmer stools heal fistula?

[Elizajp]

My crohns is not technically active but I have a fistula that is healing at an absurdly slow rate. I tend to go to the bathroom 2-3 times a day and to a normal person it would look healthy- slightly on the looser side, like Bristol scale 4, but healthy. However this amount of firmness always irritates my fistula and makes it hurt and drain. But if for whatever reason I go and it's a little firmer, like almost too firm, I have zero fistula drainage and pain. It's wonderful! And I don't feel constipated or uncomfortable. Anyways, I just don't understand why the tiniest difference in firmness makes such a difference and why the technically healthier stool seems to be so aggravating. Should I essentially try to constipate myself?? How do I firm up the stool like that? Can fistula drainage really have to do with something so simple and mechanical or is it always systemic inflammation?

 

[earthshine]

Really interesting. I would be interested to know also

 

[Robrich]

It may be that the firmer stools are indicative of less inflammation in the colon which allows the fistula to heal and decreases the fistula activity. Definitely a good sign. Looser bowels may allow more material to enter the fistula and aggravate it.
Try to continue with whatever you're doing that leads to the improvement - diet meds all of it. Fewer bowel movements are helpful. Constipation not so much.
Topical applications may also help if appropriate.
See http://www.crohnsforum.com/showthread.php?p=899410#post899410
Good luck

 

[nogutsnoglory]

I agree with robrich that diarrhea or moosh stool probably aggravates because it goes into the fistula aggravating the infection and solid doesn't.