Fistula healing process

HI all

I’m new to this site and forum and like many newbies I come with a few questions. I haven’t been diagnosed with Crohn’s but my Dr suspects it due to a long history of up to 10 BM a day, bloating, mucus with blood, severe anaemia (including lots of IV iron replacement) and in the last 3 years it’s been one thing after another with polyps, fissures, perianal abscesses and a fistula which just won’t heal. Due to the number of surgeries I’ve had for the fistula (a very recent one) my Dr is reluctant to rush and do a colonoscopy.

My question is related to the Fistula and I was hoping those who have experience of it could offer a bit of advice. Over a year ago I had a couple of perianal abscesses drained and they discovered a high fistula. I had a seton inserted to let it drain out for 3 to 4 months, after that I had the plug but that didn’t stop the discharge and 5 months after that I had my most recent operation a few weeks ago to lay it open. My colorectal surgeon said it was quite low with lots of granulation so he cleaned it up and laid it open. I’m assuming that as it was now low that part of it had healed. Two weeks on and I’m still getting discharge which I assume is normal and I’m not too concerned about as it’s much less than it was before the operation. My only worry is that I can still feel gas coming out of the fistula and at times stool with a little blood (sorry I know TMI). I’ve also had a few bouts of diarrhea which my GP says is actually better than if I was constipated as it minimises straining and pressure on the fistula – but I am concerned about infection. Does anyone know how long it roughly takes for a simple/low fistula to heal. There has been quite a bit of itching in that region so I’m hoping that it’s finally closing up but at the same time I am worried about why there is still gas coming out and if this means it’s not healing correctly.

Sorry if these seem like impossible questions and I’m not expecting answers as I know everyone is different and those are questions for my Dr’s . I’m just looking for insights from people who have been through similar experiences and what I can expect.

I had a fistula lay open – fistulatomy. It took about 6 weeks for most of the inside wound to heal – about 80%, but unfortunately it never healed on the outside – I now have a keyhole deformity. I leak post BM and have to use wipes few times after each BM. I was told about 1% of people may have this happen. What type of meds are you on? Sounds like your Crohn’s is not under control with the symptoms you describe. I tell people with active inflammation not to go for fistulatomy and try to heal fistulas with meds – antibiotics in combination with biologics. Lots of people had great results with Remicade – I could not take it – developed reaction on the 3 dose.

I am now on Humira and doing a lot better – no more fistulas, no more blood or cramps.

I wish you all the best!

Thanks for all the replies and useful to know – I’m really hoping that it finally heals this time. No it’s only been treated with surgery – I’ve had a round of antibiotics but my Doctor tries to avoid prescribing antibiotics as much as possible as he has a huge fear of antibiotic resistance and that it will make my bowel issues worse.

Ides In terms if the colonoscopy my GP feels that I've had so many operations for the fistula that a break of a few months would be useful to allow healing etc - my colorectal surgeon doesn't necessarily agree with this.

A huge part if not being diagnosed is mainly my fault. As a teen a I had a long period of BM with blood and never told anyone due to embarrassment and when I was at university and I had a very long period of diarrhea, blood, mucus etc I put off getting any tests done as it would of meant going home to London and I didn't want to compromise my grades. Then of course I graduated as the financial crisis kicked off and being one of the lucky few with a good job the only time I allowed for Drs was to ‘treat and manage the symptoms’ such as having to see a haematologist for the IV iron and fistula surgeries this due to two very bad periods where I managed to lose almost a pint of blood from bowel movements in a day and my haemoglobin and ferritin levels both crashed and seeing to the fissures/fistula etc.

Ny-sooner the SCD diet looks very similar to what I’ve done over the years to manage my problems mainly through a process of elimination i.e. I have a very plain diet which is completely grain, gluten, legume and dairy free as well as anything processed or sugary. I literally live on grilled chicken breast, boiled vegetables such as carrots and squash – anything like broccoli, spinach or raw vegetables and fruit is a nightmare, eggs and stewed fruits.