What’s a fistula? No, it’s not a fancy kitchen tool like a spatula! If you haven’t been diagnosed with one, chances are you’ve never heard of it. Fistulas aren’t very common in developed countries like the U.S., but they can happen for various reasons. In fact, about 35% to 50% of adults with Crohn’s disease will develop a fistula at some point.
Let’s break down some of the common questions about fistulas, from what they are to symptoms, diagnosis, and treatment options.
### What Is a Fistula?
A fistula is an abnormal connection or tunnel that forms between two organs or areas of the body that normally don’t connect. This can allow substances like urine, stool, or bodily fluids to pass where they shouldn’t, leading to infections and other complications. Fistulas usually form when internal inflammation causes sores, which worsen over time and tunnel through tissue. They can result from surgery complications, injuries, trauma, or conditions like Crohn’s disease and ulcerative colitis, which are types of inflammatory bowel disease (IBD).
### Types of Fistulas
Fistulas can develop in different areas of the body, including the intestines, skin, and reproductive system. The most common locations are often associated with the urinary and reproductive systems. Here’s a breakdown of the more common types:
– **Urinary Tract Fistulas**:
– A **vesicovaginal fistula** connects the bladder and vagina and often results from a previous hysterectomy or difficult labor.
– A **vesicouterine fistula** connects the bladder and uterus.
– A **urethrovaginal fistula** forms between the urethra and vagina.
– **Anal and Perianal Fistulas**:
– A **rectovaginal or anovaginal fistula** creates an opening between the rectum or anus and the vagina.
– An **anorectal fistula** forms between the anal canal and the skin around the anus.
– A **colovaginal fistula** connects the colon and vagina.
– **Other Types**:
– An **entero-enteral fistula** occurs between two parts of the intestine.
– An **enterocutaneous or colocutaneous fistula** forms between the intestines and the skin.
### Symptoms of a Fistula
Symptoms depend on where the fistula is located and how severe it is but are often uncomfortable and embarrassing. Common symptoms include:
– Leakage of fluid, feces, gas, or urine from the vagina
– Pain or irritation, especially when sitting, moving, using the bathroom, or coughing
– Frequent urinary tract infections
– Nausea or vomiting
– Open skin sores that drain fluid or feces
– Diarrhea
– Abdominal or pelvic pain
Living with these symptoms can feel isolating and significantly impact your quality of life.
### How Is a Fistula Diagnosed?
If you’re experiencing these symptoms, it’s important to talk to your doctor to rule out other issues and start treatment. Diagnosing fistulas depends on the type, but external fistulas are often easier to identify because they’re visible. For internal fistulas, doctors may use tests like ultrasounds, CT scans, X-rays, or endoscopies to locate them. Other tests might include urine samples, blood tests, or specific imaging techniques to analyze your urinary tract or nearby organs.
### How Are Fistulas Treated?
Small fistulas may heal on their own with medication and non-invasive treatments. However, surgery is usually required for most fistulas to restore normal organ function. Surgery generally involves closing the fistula, removing damaged tissue, and allowing it to heal properly. For example, after repairing a vesicovaginal fistula, patients typically wear a bladder catheter for about two weeks to support healing.
Recovery times vary, but surgical wounds may take several weeks or months to heal completely.
### Can You Prevent a Fistula?
While it’s not always possible to prevent fistulas, some steps can reduce your risk:
– Eat plenty of fiber and avoid high-fat foods.
– Stay hydrated by drinking plenty of water.
– Maintain good bowel and urinary habits.
In underdeveloped areas, obstructed childbirth is a leading cause of vaginal fistulas. Providing access to prenatal and obstetric care in these regions is critical to prevention.
### The Bottom Line
A fistula is an abnormal opening that creates an unwanted connection between organs, which can lead to infections and other complications. Although living with a fistula can be overwhelming, there are effective treatment options available. If you’re experiencing any of the symptoms listed above or think you may have an underlying condition like IBD, reach out to your doctor or a specialist for help. Early intervention can make a big difference in your recovery.