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Posted 3/4/2015 9:40 AM (GMT 0)
Hi all,
I had an intersphincteral abscess (surgeon wrote "very large" on my notes) that was drained about a fortnight ago. Never had anything like it before. When I was discharged and the visiting nurse started packing the wound I noticed a lot of faeces coming out and saturating the packing.. Hence, back into surgery two days later to have a seton fitted.
I am not getting any real discomfort from the seton but I had a few questions to ask if anyone can help?

There is still some faeces coming out of the fistula. Is this normal? The discharge is quite yellow but fairly odourless, only a very slight odour.

I had some increased pain yesterday from the fistula wound and then had a large amount of drainage. Is this normal?

The fistula is apparently 7mm wide internally, does anyone else know if this is very large and how this will affect healing time?

Does being fitted with a seton mean I do have a complex (sphincter damaging) fistula, or is just because it's quite large and draining faeces?

I don't have crohns (according the surgeon) and have no symptoms really. Just wondering what recovery time I can expect?

I have some aching pain when standing and walking in my posterior muscles radiating down into my pelvic floor. Also difficulty holding in stools as I get a bit of pain when I need to go and find it quite hard to hold. Will this improve?

Sorry guys, lots of questions and hope this is in the right place. I eat no dairy, very little bread and mostly fruit and veg. Also having regular sitz baths and drinking 10-15 glasses of water a day. Thanks for any information you might have.
Posted 3/4/2015 5:49 PM (GMT 0)
I would go to a GI because fistulas just don't happen for no reason.  You have some type of inflammation going on somewhere in your colon like crohns or UC, and the faster you get it under control the better off you will be in the future. Even if you don't show other symtoms, something is going on. 

I had two massive rectal fistulas that surfaced about an inch from my anus and tracked to my splinkter when I was diagnosed in 2007. Surgeon also said he saw no CD and installed setons.  I went to a GI and he did a colonoscopy and took samples and found CD in my colon. He wanted me to go on remicade to heal the fistulas, but i refused and decided to try a more conservative approach first after doing a lot of research.

I healed my fistulas by going on the SCD diet.  After 6 months of fanatical dedication to the diet, both fistulas were healed so much the surgeon had to remove the setons so they would heal all the way.  He said he never in his whole career had seen fistulas as big as I had heal without drugs,. To this day I am symptom free from my CD and the only drug I take is pentassa and I still follow the SCD diet, but not as strict as before.

Read the book "breaking the vicious cycle" which goes into detail about the SCD.  The diet does not always work in everyone, but it seems to work best in newlly diagnosed people with little damage.  It is not an overnight fix and takes months of dedication before you start top see results.  I started to see healing after 3 months.  You have nothing to loose by trying and all to gain if it works for you. 

Posted 3/4/2015 6:01 PM (GMT 0)
Thanks for response. You are right and I will get it checked out, however I was told by my colorectal surgeon that the fistula was caused by a very large abscess that formed as a result of infection in the anal glands. I wonder if this could be related in some way to the glandular fever I had for two weeks prior to getting the abscess?
Posted 3/4/2015 6:26 PM (GMT 0)
I wouldn't take any chances, go see a GI and ask for an colonoscopy or a test for crohns. Better to be safe then sorry. Like I said, my colo retal surgeon said the same thing "I don't see any signs of crohns"  but GI took a biospy and had it analyzed and there it was  CD in its early stages.
Posted 3/4/2015 6:58 PM (GMT 0)
Thanks for the advice, I will do that. I think they have sent off a sample or something so I wonder if that will confirm if there is crohns or not?
Posted 3/4/2015 7:15 PM (GMT 0)
Fauves are you male or female? Women can get fistulas without having an IBD, they can be caused by trauma during childbirth usually if it's a long labour and the baby spends a lengthy time making it's way out and/or big babies causing damage as they make their way through the birthing process.

IBD alone isn't the only cause of fistulas and I just wanted to clarify that.
Posted 3/4/2015 11:24 PM (GMT 0)
That sounds kind of like a large fistula. As long as there is a seton in, you will most likely have drainage. Think of it like a tunnel. The seton is there to prevent the tunnel from closing on the outside and then form another abscess and stuff tries to come through the tunnel. A seton can be put in any kind of fistula. A bit of pain is not unusual, especially right after surgery. Hopefully it should improve, but it might not ever completely go away.
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