I have a fistula but I'm not sure how to even describe the type.

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Hi

First things first - I live in Japan, speak Japanese, but sometimes don't know how to translate things to look stuff up in English. I've had Crohns for 20 years, with some surgery in the past and remission for most of that time. I take Pentasa and loperamide.

So, I have a fistula, confirmed by an x-ray session with contrast media today.

It goes from inside my rectum into the flesh of my bum, and stops there. It's like a little narrow wiggly tube. Doesn't go into my bladder, or out onto the surface of the skin. Had it about 6 months, but I had a similar pain about 5 years ago that eventually went away, so either I've had it a long time or I had one in the same area and it healed and came back.

The doc wants to do more tests (colonoscopy next) and get some more opinions, both surgical and medical. We talked today about antibiotics and hope, Remicade, or a stoma and bag as some of the possibilities. I was a bit freaked out, so my Japanese ability plummeted, and I didn't ask questions such as 'doesn't a bag sound really drastic?'

He says the opening is too far into the rectum to use a seton, and that there is narrowing higher up which may reflect ulceration, and if there is ulceration that might be the cause of the fistula and affect his treatment choices.

Stomas and bags scare the cramp out of me, haha, so obviously I want to research it.

So first question - what do you call a fistula that doesn't go anywhere?

A peri-anal in waiting? Does it even count as a fistula?

Any advice would be much appreciated.
 
Last edited:
Hi Niallism, the term you're looking for is a sinus. All fistulas start out as sinuses I would imagine, until they reach another an exit point. Technically it's not a fistula, however, I think it would be considered a perianal fistula for treatment purposes.

Best wishes.
 
Aussie is right on with sinus. I have a couple they call sinus tracts.
Here are my thoughts but i'm not a doc and we are all different right! If he's talking remicade and you are not ready for the stoma then you can just try the remicade first if meds are what your looking for. For me, my deciding factor was pain, it hurt so bad to have a poop. I currently have a temp loop ileostomy to help aid in the healing of my abscess,fistula,sinus tracts. I am very happy with my decision and am happy to not have extra pain while pooping :) It is temporary and can be reversed as I would think yours would be to. Lots of info in the stoma section and even videos on youtube on how to change a bag and what not. Do your research so you have all the info to make a decision that suits you best! Good luck!
 
The current approach to closure is a combo of Flagyl and Cipro. Generally they'll go there before surgery. Remicade and the biologicals can also help them heal, so that is another possibility. If it is close to a perinatal fistula (the channel is almost through) they can try a fistulotomy, but that should be a secondary option due to rectal scar tissue having bad side effects.
 
I agree with AlliRuns. For me personaly, the two meds (cipro and flagyl) only worked while I was on them and then once it was out my system the symptoms came right back
 

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