Help Please! Possible Fistula. What Questions and Tests should I ask GI about?

[jac521]

I have been having visible blood in my urine. I went to an urgent care facility yesterday and I was told I had blood in my urine and that it could possibly be the beginning of a fistula.

The Dr. put me on Flagyl and I was already taking Leviquin for Sinuitis and Bronchitis.

The urgent care told me to go to my GI Dr. I have an appt. tomorrow.

What questions do I need to ask the GI and what tests should be performed?

Thanks.
Jac

 

[exit4]

Are you having blood in urine or stool? I am not sure about urinary fistula diagnoses, but the fact that urgent care is sending you to GI, tells me that it maybe intestine/anal fistula.
Here are some ways that anal fistula is diagnosed.
Physical examination
The specialist will examine your anus (the opening where waste leaves the body) and the surrounding area for any physical signs of a fistula. The opening of a fistula usually appears as a red, inflamed (swollen) spot, which often oozes pus.
If the opening of the fistula is found, the specialist may be able to work out where the path of the fistula lies. The path of the fistula can sometimes be felt as a hard, cord-like structure beneath the skin.
Digital rectal examination
Your specialist will also perform a digital rectal examination (DRE). This involves placing a finger into your anus. During the DRE, the finger will be covered with a glove and lubricated with gel.
The DRE allows your doctor to find out where the internal opening of the fistula is, and if there are any secondary tracts branching off it.
During the DRE, your doctor may ask you to squeeze your sphincter muscles (the rings of muscles that open and close the anus) around their finger, to assess how well they are working.
Fistula probe
Your specialist may also need to use a proctoscope (special telescope with a light on the end) to see inside your rectum. They may also use a fistula probe, which is a tiny instrument inserted through the fistula.
These examinations may be performed under general anaesthetic, where you are asleep.
Some further tests that may be recommended include:
Anal endosonography (ultrasound) – this test uses high-frequency sound waves to create an image of the inside of your body. This is an accurate and frequently used way of locating the internal opening of a fistula.
Magnetic resonance imaging (MRI) scan – an MRI scan uses strong magnetic fields and radio waves to produce a detailed image of the inside of your body. This type of scan is often used in cases of complex or reoccurring fistulae.
Computerised tomography (CT) scan – a CT scan uses X-rays and a computer to create detailed images of the inside of your body. This may be used if you have an inflammatory bowel disease, such as Crohn’s disease, as it can be used to assess the extent of the inflammation.

 

[Ihurt]

I am hoping they sent your urine off to cuture for infection?? I also get blood from time to time, not visible, but it is picked up on urinalysis. Just because you have have blood does Not mean you have a fistula. DO you have any other symptoms like fecal matter in your urine when you pee?? Also, do you have pain in the bladder? I hope you do not have a fistula and that it is just a infection or something. Do you see the blood all the time, every time you pee??

I have been having visible blood in my urine. I went to an urgent care facility yesterday and I was told I had blood in my urine and that it could possibly be the beginning of a fistula.

The Dr. put me on Flagyl and I was already taking Leviquin for Sinuitis and Bronchitis.

The urgent care told me to go to my GI Dr. I have an appt. tomorrow.

What questions do I need to ask the GI and what tests should be performed?

Thanks.
Jac

 

[Ihurt]

Oh, also, I know the urgent care place you went probably did that dip stick test where they check the urine. Well FYI, even if it comes back showing no nitrates or WBC's, it does NOT mean there is no infection. I have had those dip stick urine tests done Tons of times( I am very prone to UTI's) and they hardly ever show the nitrates and WBC's which indicate a infection. But when I send my urine off to culture that shows the bacteria and infection... It is a must that you have your urine sent for culture becasue only a culture will show if you have an actual UTI or not( and even they do not always pick them up.)

 

[jac521]

Oh, also, I know the urgent care place you went probably did that dip stick test where they check the urine. Well FYI, even if it comes back showing no nitrates or WBC's, it does NOT mean there is no infection. I have had those dip stick urine tests done Tons of times( I am very prone to UTI's) and they hardly ever show the nitrates and WBC's which indicate a infection. But when I send my urine off to culture that shows the bacteria and infection... It is a must that you have your urine sent for culture becasue only a culture will show if you have an actual UTI or not( and even they do not always pick them up.)

Thanks Ihurt - I am going to call the urgent care and see if they sent the urine for culture. I have never seen blood in my urine before this.

The urgent care Dr. also asked me if I had diverticulitis and when I had a colonoscopy a couple of weeks ago the GI told me I did. However, the GI Dr. told me it was "nothing". I have been in abdominal pain, with a throbbing pain at times and nausea for over a month and extreme weakness. After the urgent care Dr.added Flagyl to the Leviquin I had been taking, I am starting to feel the best I have in weeks. My new GI also told me the diverticulitis was "nothing". I am confused???

 

[exit4]

Diverticulitis is NOT nothing!.
When a diverticulum (small outpouchings (sacs) that push out from the walls of the colon ) ruptures, bacteria (always present in the colon) can spread into the tissues surrounding the colon and cause infection and inflammation. This is called diverticulitis. I would question your GI on why he thinks its nothing.

 

[Ihurt]

Are you meaning that the doctos said diverticulosis is nothing? Divertiulosis is not concerning in itself. Now divertiu-litis would mean there is a diverticula that was infected. I am guessing your gastro meant he seen diverticulosis and that is not a huge issue as most people over the age 50 have them...

Also, I would definitely see your primary care doc so she can send out the urine to culture if the urgent care did not. A lot of times the urgent care will just do that dip stick tests and if it is not too bad, they wont go any further( sad is that is!). Your urine should be sent for culture. There are Many things that can cause blood in the urine( kidney stones, UTI, medications, IC, etc..). I am glad the meds are helping you feel better...

Thanks Ihurt - I am going to call the urgent care and see if they sent the urine for culture. I have never seen blood in my urine before this.

The urgent care Dr. also asked me if I had diverticulitis and when I had a colonoscopy a couple of weeks ago the GI told me I did. However, the GI Dr. told me it was "nothing". I have been in abdominal pain, with a throbbing pain at times and nausea for over a month and extreme weakness. After the urgent care Dr.added Flagyl to the Leviquin I had been taking, I am starting to feel the best I have in weeks. My new GI also told me the diverticulitis was "nothing". I am confused???

 

[jac521]

Thanks a bunch exit and Ihurt!!!!

I called the urgent care and naturally they didn't send the urine for culture.

The bad pain that I have had for over a month is now gone since I started the flagyl along with the Leviquin My GI kept saying it was a Crohn's flare in my small bowel and wanted to do a pill cam to see if there was active disease there. (I am on Entocort)

If an urgent care Dr. could figure out that it was diverticulitis that was causing the high WBC and pain, I find it hard to believe that the GI couldn't???

Why do I always feel that these GI Drs. are constantly jerking me around???

Thanks.
Jac

 

[exit4]

I know what you mean with GI docs! It took me a long time to find GI that actually listens and cares. I am glad you feel better with flagyl - The fact that it made you feel better tells me you may have had an infection. It is very strong and it worked for me also but it made me nauseous.

 

[jac521]

The fact that it made you feel better tells me you may have had an infection. It is very strong and it worked for me also but it made me nauseous.

I just got back from the GI Dr. He said if I had a bladder fistula brewing I would have other symptoms than blood in my urine. He told me to have a urine culture done.

I told him how much better I felt because the urgent care put me on Flagyl and that I now have some energy and am not laying in bed all day in pain. He said it could have been diverticulitis but that my colonoscopy a few weeks ago didn't show anything active.

He still wants me to have the pill cam done ASAP.

What kind of infections would Flagyl treat? I feel so much better on it.

Thanks.
Jac

 

[Ihurt]

I know my best friends husband has Ulcertive Colitis. He ate some mexican food a couple weeks ago and he was already in a flare( but his flares are usually manageable, I mean it sucks but he usually gets by.) Well after he ate that food the next morning my friend said he was soooo sick, water diarhea and blood. I mean every 20 minutes. They ended up going to the hospital and they gave him fluids and took stool samples. Well they sent him home with flagyl and cipro in case he picked up a bacteria in the food( ecoli or something). Well they said they did not find any bacteria, but he is feeling better with the flagyl so he thinks he did pick something up, just the labs are not always reliable.

Maybe you have a slight infection. I mean if you just had a scope and the GI did not see any sign of diverticultiis, then it is likley not that. Diverticulitis pain is uaually on the left lower side as well, not sure where your pain was located. Anyhow, I seems like doctors put everyone on flagyl that has a gut issue. That really sucks for me though as God forbid I ever need it, I cannot take flagyl nor cipro due to severe side effects I get! In fact I cannot take most antibitoics due to adverse reactions.

Glad you are feeling better, hope you continue to do well..

 

[jac521]

Hi Ihurt and Thanks!!

The scope showed diverticulitis(?) all through my colon. The Dr. said it was nothing who did the scope. My new Dr. told me today that the diverticulitis(?) wasn't active at the time of the scope.

The pain I have is on my left side in the middle of my abdomen. I would get nauseated as well. Lost 20 lbs in one month. At times the pain would throb.

The Dr. said that Flagyl and Cipro are used to treat Crohn's and that it lowers inflammation and maybe that is why I am feeling better. My WBC was 17.0. I don't know how they determine what is inflammation and what is infection from a blood count?

I have so much to learn and everyone has been so helpful!!

Thanks alot.
Jac

 

[exit4]

I took Flagyl to treat c diff. Had to be on it 2 times as c diff cameback after one month.

 

[Ihurt]

I am guessing that the dr saw Diverticulosis all throughout the colon. When the diverticula become infected, then it turns into diverticulitis which is Very serious and needs treatment. One thing to know is since you have the diverticulosis, you should avoid all seeds and nuts of any kind as they can get stuck inside the little pouches of the diverticula and cause infection. Also try and make sure you do not get consitpated as this can worsen the condition.

Glad the cipro and flagyl is working for you.. Hope you continue to feel better and better!!

Hi Ihurt and Thanks!!

The scope showed diverticulitis(?) all through my colon. The Dr. said it was nothing who did the scope. My new Dr. told me today that the diverticulitis(?) wasn't active at the time of the scope.

The pain I have is on my left side in the middle of my abdomen. I would get nauseated as well. Lost 20 lbs in one month. At times the pain would throb.

The Dr. said that Flagyl and Cipro are used to treat Crohn's and that it lowers inflammation and maybe that is why I am feeling better. My WBC was 17.0. I don't know how they determine what is inflammation and what is infection from a blood count?

I have so much to learn and everyone has been so helpful!!

Thanks alot.
Jac

 

[2thFairy]

Like Ihurt said, there is a difference between OSIS and ITIS in connection with diverticulum. DiverticulOSIS is not concerning, but does need care with diet and staying regular. DiverticulITIS needs to be treated with medication and sometimes surgery.

When your doctor said that your diverticulosis was not active at the time of colonoscopy, he meant that there was no infection present. Flagyl helps infection plus provides some amount of pain relief.

I am glad you are feeling better.