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Fistula plug -- doctor knowledge and post-op healing time?

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Posted 12/20/2012 7:50 PM (GMT 0)
Hi,

I was diagnosed with a fistula today -- going to have an MRI next week to determine if it is going to potentially impact the spinchter muscle or not.

My doctor was VERY nonchalant about this condition -- he said his dad had one and chose not to have surgery. So, I have a couple questions for this great community:

1.) I am currently on an antibiotic. In the past, I have been on antibiotics and the bloody/***** thing near my anus has cleared up, but then it has returned several times. Is it possible for leviquin to potentially heal this for good?

2.) Fistula plug surgery: Are most surgeons fairly confident with this procedure? In other words, do you think I could ask my colorectal/general surgeon to use it, or are many doctors put off by using it? Today, he just said he would open up the fistula track, clean it out, and then it would 'heal'. He didn't mention possible plug use, but I am horrified by incontinence.

3.) Fistula plug surgery: What is the post-op recovery period like when using a fistula plug? Do you need to do constant wound dressings, etc.? about how long does it take?

Thanks very much!!
Posted 12/21/2012 11:38 AM (GMT 0)
Sorry to hear you are dealing with a fistula. Please make sure you ONLY use a CR surgeon...you really don't want to take chances with that area!

Infortunately my body was too diseased to try the plug or flap surgery so I cannot answer those questions.

I did have Setons to keep mine open and was on Cipro (allergic to Flagyl) to help. Remicade did close mine but my body didn't like it...and they opened back up.

Welcome to the forum:-)
Posted 12/21/2012 11:41 AM (GMT 0)
Thanks for the thoughts!
Posted 12/21/2012 11:42 AM (GMT 0)
I have about a 1 CM by 1 CM abscess/puss ball in the perianal area. Thus far, that seems to be my only symptom, aside from some random shooting pains at time. Currently on levaquin, which is helping reduce inflamation.
Posted 12/21/2012 11:42 PM (GMT 0)
After finding out that the fistula plug was only 10 percent successful I chose to have surgery. My CR doctor informed me that it will take up to 3 months to heal but I am optimistic because I have been dealing with this for off and on for a year and ready for it to be over with. I have to say that after the surgery there is a lot of discomfort and dealing with the bowel movements and cleaning up your self after is a pain.
Posted 12/21/2012 11:45 PM (GMT 0)
Sorry, Bizz -- how bad was your fistula?
Posted 12/21/2012 11:54 PM (GMT 0)
My doctor considered it sever. I wish I would have went to the CR doctor right away instead of just a general surgeon when my abscess came back because he said f I wouldn't have waited it wouldn't have been so bad. My sister had a plug put in and after several weeks of pain it was unsuccessful and she ended up having surgery as well.
Posted 12/21/2012 11:58 PM (GMT 0)
Yes, I am still confused -- my surgeon said that many people just 'live with these things' -- and his dad lives with one -- and I could as well. He did not stick his hand up my anal canal, but diagnosed it as fistula based on about a 1 CM x 1 CM abscess. He said he would have to have an operation to know for sure, but I decided to have an MRI first so that we could make sure of the track -- and any other conditions/issues.

Yes, I also wish I had been to a proper surgeon sooner -- my GP in August just said it was infected anal fissure and gave me an antibiotic, but I have also read that many times anal fissures > abscess > fistula?
Posted 12/22/2012 12:06 AM (GMT 0)
Yup. I had surgery on an abcess about 8 months ago and it healed up ( took about 6 weeks) then one came back in the same spot and the general surgeon opened it up and had me pack it and it came back twice and that's when I went back to my CR surgeon and he told me after doing a quick rectal exam that I had a fistula.
Posted 12/22/2012 12:22 AM (GMT 0)
Hmmm...I have about 1 cm x 1 cm of puss/bloody abscess and then below it is some skin that feels more dense/leathery than other skin on my butt cheeks.
Posted 12/22/2012 12:41 AM (GMT 0)
Sounds like what I had. The abcess is on bottom of my butt cheek. The fistula starts at the anus and was about to hit the abcess when I had surgery. My CR doctor told me 50 percent of people who get abscesses get fistulas as well. He said them recurring after the surgery I had is rare. He did a colonoscopy at the same time I had my surgery and said it was more sever then he thought and that it would take me 3 months instead of two to heal but I didn't have CD.
Posted 12/22/2012 12:56 AM (GMT 0)
Yes, I don't have CD either...I don't think. What surgery did you have? How is the healing going? Were you in a lot of pain prior to the surgery? Right now I would describe my pain as like a 0.5, but I am also taking an antibiotic at the moment. Curiously, my surgeon suggested I should just stop the antibiotic, which I don't understand given I have an abscess-like thing in my butt cheeks with white puss.
Posted 12/22/2012 12:58 AM (GMT 0)
Also, was your doc 100% certain you had a fistula prior to surgery? How could he be that certain if it is just 50/50? I'm just wondering what signs to look for -- I don't have my MRI until next Friday...and then don't get the results until 3 January. I'm tired of guessing! :(
Posted 12/22/2012 1:12 AM (GMT 0)
The strang thing is my MRI didn't show a fistula according to my general surgeon but my CR surgeon knew it right after doing a rectel exam. He took pictures of the fistula during my colonoscopy before he did my surgery. I think I may have mislead you earlier. My doctor knew I had a fistula he just told me when I asked how a person gets one is when he told me 50 percent of people who get an abcesses get a fistulas. The pain is up and down and depends on how much I set down.
Posted 12/22/2012 1:18 AM (GMT 0)
Ohhhh, ok. Thanks. Wow, I'm getting an MRI so that my surgeon can try and make out the course of the fistula(s). I hope he can see it after all that cost!
Posted 12/22/2012 1:21 AM (GMT 0)
Did he do the colonoscopy at the same time as your surgery?
Posted 12/22/2012 1:24 AM (GMT 0)
Yes he did a colonoscopy then the surgery
Posted 12/22/2012 1:30 AM (GMT 0)
Thanks -- so is there anything you can tell me that I should be looking and/or feeling for to confirm this is a fistula vs. just an abscess?

I'm wondering if it was my anal fissure > abscess > fistula?
Posted 12/22/2012 1:34 AM (GMT 0)
Did you have this throbbing constant pain before surgery?

a throbbing, constant pain that may be worse when you sit down, move around, have a bowel movement or cough
Posted 12/26/2012 8:13 AM (GMT 0)
One thing to remember is that fistulas don't show up all that often on MRIs. I know a girl who only had 3 show up, but then when they opened her for surgery they found 18.

Find out what exactly they're doing in the surgery. Also, are you on any maintenance meds? Besides antibiotics? Those might not be the best for healing fistulas. Are you taking probiotics while you're on them?
Posted 12/28/2012 12:27 AM (GMT 0)
In case it is of any help, I had 2anMRI which was uncertain regarding rectovaginal fistula, however what confirmed it was an ultrasound. A quick and rather painless procedure and the good thing was I got the result from the Dr who performed it there and then. I was grateful to have a proper diagnosis, at last. I persisted with the DR to get a firm diagnosis, I think we all need to use our intelligence rather than allow for a vague 50/50 response from the Dr's, if at all possible. We need to keep ourselves as well informed as possible to get the best possible success with these most wretched things. Good luck to everyone!
Posted 12/31/2012 8:35 AM (GMT 0)
Hello, I was wondering how your appt went? The procedure I had was a cut that goes from my abcess to my anus where the fistula is. It is about 3 inches across and about 1.5 inches in depth. It's gross because when I have a bowel movement it comes out all thru my buttcheek. The smell the first few days after the procedure was bad but I quickly learned to take a shower and use a handheld shower head and rinse it with Luke warm water and a mild bath soap right after a bowel movement. My doctor said it will take 8 to 12 weeks to heal but said due to me keeping it so clean and keeping a 4x4 gauze (i put it between my cheeks and it stays put) as well as a thin pad on at all times I am healing very well. I have worn baggy pants. My doctor said its a long healing process due to it having to heal from the inside out.I have a yellow thick discharge but he said that is the normal healing process. I also take a stool softener every night before I go to bed to keep my bowels soft. If you have any other questions at all please do ask and I can tell you what has helped me out because I know it's scary.
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