Life after Seton placement

Anyone out there have a good experience after having a seton placed to keep a fistula open? I had mine installed 9 days ago. The doc actually installed 4 rubber band setons because i have two different openings in one fistula. The longest one is installed between the anal opening all the way to the end of the fistula. The second one is from the anal to the middle opening. Another from the middle to the end and honestly i am not sure about the last one exactly. Its very hard to wipe around this area unless i use a huge supply of toilet paper and pat it clean several times. I have been doing baths twice a day and there are times that this sucker drains alot. The gi surgeon Doc said it will probably only last 1 year and then i will need to get another one. My general gi doc says that if i respond positively to the humera and my chrohns goes into remission then there is a good chance i might not need another seton but i am confused because the surgeon says i should always have one in to avoid a potencial infection or absess in the future. After reading posts part of me thinks it might just be best to live and push for a colostomy and avoid absessss for the rest of my life because they are the worst thing that can ever happan to someone and then chances are you will just get another fistula and seton placed if you did. I suspect that since i didnt get a cutting seton there is to much muscle in this area.
-Robo

I have 3 sep setons. I've had then since December. My surgeon said once the Remicade starts working I should be able to get them taken out since it'll help them close up. I also had an abcsess so I have a drain in for that. I wear a panty liner to protect my clothing but my surgeon recommended a few squares of gauze folded in half and placed between my buttcheeks to catch the drainage at the source to avoid irritation to the skin due to being wet all the time. I do a sitz bath occasionally and after going #2 always sitz after wiping the best I can or shower, I have a removable shower head which gets things really clean. I recommend baby wipes too! Goodluck, I don't think the surgery is something I'd consider at this point in my life. The setons aren't the worst and like the person above mentioned, because you get it once doesn't mean you will get it again necessarily. Hopefully your meds get you in remission. Goodluck!

Hi Rob and welcome. I would say I probably had one of the best and easiest setons in the world. So I might be an extreme example, but wanted to give you the positives.
Had my fistula longer than the seton because I didn't know what it was. antibiotics were helping, but I had a bad side effect to them. My fistula was perianal. They put in the seton and I had a good bit of draining for the first week or two...had been draining for some time before that though. I used a lot of feminine pads situated near the seton to help pull the drainage away from my sensitive skin. Every 4-6 weeks, they tightened mine...but it was because the fistula was healing from the inside out (I use the straw example---the lining in the straw was healing and it was turning into a stir stick). Eventually my seton came out as it healed through.

Yes, I have been told that once you have a fistula your chances of more are bigger. However, I have been lucky and had the one 13 years ago and none since. I was told to consider biologics to prevent a future one...13 years later I am still thinking on that but Ihave heard wonderful things about them helping fistulas.

Alcohol - yeah not always a good thing. Some can handle it better than others. For me, even a couple of sips of beer or any grain alcohol cause me discomfort to pain. I can manage 1-2 glasses of wine, but it also effects my GERD. If I do have alcohol, I stick to expensive vodka made from potatoes as it has been the least disruptive, but even that only works on my better days.

Take Care

I'm pretty sure they can heal but you are higher risk for their return. My surgeon advised me that in my case the setons will stay in for quite some time. He also gave other options for getting rid of them but the seton was the least invasive and wouldn't make me suffer with incontinence. Healing is possible :)

Thanks for all the good feedback. What kind of options did he give you to get rid of the setons? Seems like letting a fistula heal is a risk- risk of a recurring absess and if thats the case i prefer to keep a seton in place ans continue to have them changed out every couple years