Rectal pain following fistula operation - Looking for advice

Hi all,

I am after some advice from anyone on here. My situation is this; I got a perianal abscess which was drained twice before they found a fistula. I had an advancement flap to close an internal opening but my external opening kept draining, plus I had the ache and throb that would follow a bowel movement. The ache and throb would last a couple of hours and then go away. Finally I got an MRI which showed the flap operation was successful but I had a small internal opening high up in my rectum. My specialist then performed an operation in which he stapled the internal rectum opening closed and then curated the fistula track and has left it to heal.

It's been 2 weeks since that operation. While I feel better in myself the external opening is still discharging. Not huge amounts but enough to wear guaze during the day. The most depressing part is that I still get the throb and ache post bowel movement. It feels like the inside of my anus is achy. It only occurs an hour or two after a bowel movement and then goes away. When I wake in the morning or I got a while without a bowel movement it's fine and there's no pain.

My question, does this mean the staple operation failed? I always thought that the throb post bowel movement was from fecal matter getting into the internal opening and my body reacting. However I don't get fecal matter draining from my external wound. Could the throb post bowel movement just mean that area where the internal opening in the rectum is still very inflamed and raw from the staple surgery and the year it was there before getting the staple op? I know people say the inside of the anus takes a long time to heal after surgery.

I'm really down about all this. I really hoped this would be the final step on the road to recovery. It's been brutal. Even though my symptoms remain I DO feel better than I did pre staple operation which is a small blessing. Hope there's someone who can advise as my specialist follow up appointment isn't for 3 months. .

Thanks in advance.

Thanks Scifigal2k, I really appreciate the reply. I hope it's that, it does feel more like an ache than a build up of the abscess again, though the ache can be quite tough to deal with for an hour or two. I didn't think that tissue inside the anus which has been stapled or sliced would heal very quickly. I guess it's just that the ache post bowel movement is similar to the ache I got pre staple surgery which is what worries me. I don't think anyone can prepare you for how awful a fistula can be.

DBrookenz, sending my support to you - I hope it quickly gets better. Good sign that things are improving.
This issue is a bit complicated and very specific, as this staple process seems to be rare.
Why don't you give them a call? Most likely they'll be reassuring.

Thanks UniformCharlie, I guess I need to just ride it out and hope for the best. I knew this would be a long haul. In the past few days I've noticed that the drainage from my fistula, while a smallish amount, has also included specks. I worry they are feral matter. My drainage prior to the op didn't really have this occur. They look brown but they are tiny and don't seem soft. It's also very disheartening. My specialist also said that the titanium staple he used to close the internal opening in the rectum stays there for quite a while. I did wonder if that is what is making the ache worse. It's such a mystifying disease! I just want to know what's happening, even if it's not what I want to hear. In many other ways I feel much better than I did prior to the staple operation. When I wake up in the morning there is almost zero drainage on my guaze from overnight and zero discomfort. it's just the ache for 3-4 hours post bowel movement and the drainage that concerns me right now. Thanks again for the advice everyone, I appreciate it so much.

Thanks for that Scifigirl, I hope you're right. The flecks have gone now, it's just a little drainage. I can never differentiate between serous drainage and pus but at the moment it's yellow, a bit soft and gooey and doesn't smell much. It's also not a lot, though enough to wear a pad.

The thing that concerns me is the ache after a bowel movement. It's weird because the bowel movement itself is fine and the couple of hours post bowel movement are fine too but then, 2-3 hours later, I start to get this ache inside my anus / rectum and sometimes it builds up and then I get a bit sweaty and it's almost like a tiny mini spasm and then after that the pain and ache subside quickly and I'm okay. This happens most days but not every day. The odd day I feel very normal. It sucks though as my job requires a lot of standing and I struggle when it aches. I think you all know how awful a pain in your rectum can be. It dictates your whole life! I did wonder if theres scarring inside my rectum from the surgery in which fecal matter is getting in and causing this. The staple op sounds quite brutal and in the first bowel movement I had post surgery I had blood and then a bit of blood in the next couple of times too. It was almost like it was raw up there or something.

Thanks for the support guys, this means so much to me!