Fistula question

 In my last post about fistula and where they go I got info that is disturbing me. While I can almost understand why a fistula that works its way out of the body is , treated , I can't understand why a fistula that works its way into the bladder or another organ of the body is not dealt with surgically . Is there some reason for allowing this to go on for , in some cases, years ? I dont get it.

Hichik , in your case I can understand the scar tissue issue , but in the case of one into the bladder this is not only painful but could be a place for infection or worse and scar tissue would be the least of my concern. In your case I would go on the remicade. I've been on it 5 years now and its really helped . Hope someone with more info comes along soon.

Does not make sense to me Nanners. What about paratinitis ? My old Army first aid training screams at me that even a small amount of fecal matter in the lower cavity of the body was bad news and infection was almost a certainty. So stern were the warnings that a gut shot soldier was even denied a drink of water to prevent washing the contents of his intestine out into his body. So now, if its crohns causing the leak, we just pump someone with meds ?? Sorry this goes against my best judgement.

But if they removed the fistula by resection of the area that is comes from I would think it would be less likely to return.

 this response goes out to mr.d: How many fistulas do you have-just curious? I was diagonised with 5-6 fistulas after my last scope in Oct.2010, followed by a Barrium enema. My GI doctor said he couldn't do surgery because he said once that you start cutting away bowel and doing resections you have a mess and mine I guess like a road map. My doctor wants to start me on Humira, but I'm waiting to get a preauth-from my insurance/drug company I guess. And in the meantime, I've developed a UTI infection that I was on antibiotics for and today they did a re-check and I still have some infection. And ofcourse my primary care doctor is gone until Monday of next week, so I'm not sure what he's going to prescribe next. It worries me now that something else is going on with my kidneys or bladder, so I'm hoping that whatever else he gives me will clear it up so I can start the Humira. I'm worried too about the side effects from this drug as well, and have also developed pre-existing liver conditions because of it. My GI doctor doesn't want to do any more bloodwork on me I guess , until after my 1st injection of the drug. And he doesn't seem to be too concerned as my husband and I were up there meeting with him last month, and I told him about being nauseated on/off and tired and itching all of the time, and all he said was" well sometimes Crohns manifests itself in different ways, and he's just going by my last bloodwork which he said was within normal limits and nothing indicated that he proceed any further with any other kind of test. I'm sure you an relate with feeling crappy and getting this test and that test. It's just getting real old!! Did you start your Humira yet?, and if so, did you have any reaction from it? Hope your feeling much better!! Take care--Silvergriz

hey all, i had the giant drainer on my abdomen for 4 years precisely because no one wanted to open that can of worms as they say... i finally found a surgeon that said she would try it. and it worked..

the main thing i think is that once the insides are cut to repair something it makes a weak spot that a new fistula can follow quite easily .. sniper you would be correct that peritonitis and sepsis is a real risk, however fistulas as a rule have made their own sealed tunnel to wherever they are going so in reality it is a sealed system. gut to skin, gut to bladder, etc.. not just free flowing sewage rolling around inside ya. i will assume that a bladder linked fistula would require some anti biotics from time to time .

the time i had 6-7 fistulas to my skin was because the main one had split and followed my many surgery tracks that were weak and went right up to the skin. . its misserable to be sure. your skin breaks down from the stomach acid and digestive enzymes coming staright out and not a dang thing to do. good luck to all of us that have had or do have a fistula. especially to the skin or some other organ.

 This reponse goes out to Sniper: Thanks Sniper for reponding so quickly!!, That was in fact my GI doctor that aid Crohns manifests itself in different ways. I told him I think in fact last August when I had my last bloodwork with him, iI told him about my itching and fatigue, and all he said to me was that "manifests itself in different ways" What really gets me Sniper that he knows my family history and knows why the alk-phos has been according to him, minimally elevated, the MRI that they did showed why, because it was coming from my liver. He has never suggested a liver biopsy or any other test, he's just going by the numbers on the bloodwork. And he is supposed to be a specialist in Crohns/liver specialist, and this is the 2nd GI doctor I've been to. I ended up having to go to my primary care doctor for a UTI infection which still has not cleared up, so now I have to wait until he gets back next Monday and see if he is going to prescribe me more anitibotics. I'm just hoping I get rid of this so I can start on Humira I hope in a couple of weeks if everything goes okay. You know Sniper, you would think both doctors would be consulting one another, especially if there are other stuff going on. Personally I think they should either check out the gallbladder/kidneys for possible stones and the liver for possibly PSCor PBC. My 1st doc I went to back I think it was in 2008 checked me for PBC and at that time it was negative. I feel so frustrated with both of these doctors, I feel sometimes like they don't even care. Besides, I live in a small town in Montana, so unless I wanted to travel some disttance, I don't have too much choice. Although if this wasn't winter time, I think I'm getting to the point, I would consider it. Take care of yourself Sniper and keep me posted on how your doing too!!Silvergriz

I was lucky they didn't find a fistula yet from my abscess, so I send out my best wishes to all of you who are suffering through this I hope you get some relief.

My col/rectal surgeon said he was worked on people who have had fistulas all the way from their gut down their leg, I couldn't even imagine.