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What is your input on Fistula's

So I was in search of what fistula's are all about and this is the post I came up with. Here is the link (http://thecrohnsjourneyfoundation.org/all-about-fistulas/) but I copied and pasted it all here :)

Before I begin....
I was wonder if any of you dealing with fistula's would like to add anything else you think may be helpful or share your experience with it.... thanks!

What is a Fistula

A fistula connects two body cavities or a body cavity and the skin. A common way it is formed is from a abscess that is consistently filled with body fluids (i.e. stool, urine..) which prevents it from healing. The fistula formed from the abscess will eventually break connect to another body cavity, organ or break through to the skin. It is common to see fistula’s with people who have IBD (Inflammatory Bowel Disease – Crohn’s Disease and Ulcerative Colitis) and approximately one quarter of people with Crohn’s will develop fistulas.

Types of Fistulas

There are 4 types of fistulas, all occurring around the perineum (around the genitals and anus)

1) Enterocutaneous: from the intestine to skin

2) Enteroenteric or Enterocolic: involves the large or small intestine

3) Enterovaginal: from intestine to vagina

4) Enterovesicular: from the intestine to the bladder

What Causes a Fistula

Inflammation in the GI Track
Abscesses
Draining Abscesses
Symptoms

May Include… (all depending on severity and location of fistula)

pain
fever
tenderness
itching
generally feeling poorly
drain pus or foul-smelling discharge
How to Diagnose a Fistula

Depending on location… following IBD diagnostic tests can be used

barium enema
colonoscopy
sigmoidoscopy
upper endoscopy
fistulogram
intravenous pyelogram (IVP)
Complications

May form an abscess when it closes. An infection.

Fistula Treatment

Varies depending on location and severity of symptoms. List in order of medical approach.

antibiotics: metronidazole and ciprofloxacin
Immunomodulators: azathiprine, 6-mercaptopurine, methotrexate
Chimeric Monoclonal Antibody: Infliximab
autoimmune suppresent: Remicade
enteral diet
surgery
Prognosis

“The location and severity of the fistula play a major role in determining treatment. With proper care, a fistula can be treated and healed and should not re-occur.”

Sources

http://ibdcrohns.about.com/cs/relatedconditions/a/fistula.htm

http://www.medicalnewstoday.com/releases/42903.php

http://www.livestrong.com/article/220629-what-causes-fistula-to-form-with-crohns-disease/

Image from: http://www.webmd.com/ibd-crohns-disease/cd-biologics-10/slideshow-flares
 
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