I have read and heard many horror stories regarding anal fistula surgery. I have heard tales of incontinence, reccurence, severe scarring and infection.
Has anyone had sucessful surgery? Or natural medicine healing?
Stories would be appreciated.
Thanks
Natural medicine does not work...so save yourself endless misery and disappointment and don't use it. I had a fistulotomy 2 years ago and it worked beautifully- the wound was quite large, but it did not hurt and it healed completely within 3 months. The problem is that too many people are doing the wrong things when it comes to fistula surgery. So let me break it down for you-
1.) ALWAYS use a well-regarded colo-rectal surgeon....NEVER go to a general surgeon for a fistulotomy. Only colo-rectal surgeons are experienced in this kind of surgery.
2.) NEVER wait a long time to get fistula surgery- the longer you wait, the greater the chance the fistula will become more complex/more difficult to eradicate.
3.) Always opt for a fistulotomy (lay-open technique) if you can (this should always be the way to go unless the fistula is too high, in which case a cutting seton will do the trick).
4.) Use a bidet or shower head after EVERY bowel movement and eat a HIGH FIBER diet at all times. You should never be holding in your poops or straining to get them out.
5.) STOP SMOKING IMMEDIATELY if you smoke. Smoking not only decreases healing, it also opens your body up to infection and can actually help contribute to the formation of abscesses/fistulas.
If you otherwise healthy (e.g. no Crohn's or AIDS) then the success rate of a fistulotomy is >90% and the chance of any serious incontinence is very low. Also, infections of the fistulotomy wound are surprisingly rare (1-2%) since the region is fairly infection resistant.
Take it from me- I had a really large and nasty perianal abscess which created a long but low fistula. My abscess was likely caused by decades of straining on the toilet and tears.
Hi
Lots and lots of good advice here, couple of points on number 3.
A normal high fiber diet is not for everyone.
I have chronic IBS so most fiber and generally carbohydrate e.g wheat, have the opposite affect on me from what it should so yes we need fiber but it is making sure you get the right fiber for you as an individual.
I don't want to cause alarm but my fistulotomy did not work. Three months later a seton was put in place and that did not work either. The only thing that healed me was changing to a very healthy diet. Keeping to that diet has kept me abscess free for the last 5 years.
Everyone is different and each has a slightly different story. It is great to hear the fiber diet change worked for you. The correct healthy diet for you as a person alongside modern medicine is definitely the way to go.
Yes it is true that if you have other issues (such as IBS) then a high fiber diet is not ideal, but I was basing this all on the assumption that the OP was otherwise without issue. I have mild problems with fiber myself (not IBS, but excessive fiber has me pooping normal sized poops 2-3 times per day, which is annoying but still normal). High fiber can also cause excessive flatulence even in people without IBS. But the point I was making is that the goal is for the stool to be soft and easily passable.
I'm 9 weeks post fistulatomy surgery and life has gone back to normal. No incontinence, no real problems at all. I am 95% healed. I still have a small wound, but the discharge is all but gone. I still take soaks 2x per day, mostly as a precaution since I want to make sure everything is clean as can be while I heal the rest of the way. I see my surgeon again in 3 weeks to make sure I am fully healed, but based on my progress I have complete confidence that this mess is behind me (hahahahah, sorry, it's been a long day). Tulip, I think I have seen you posting for a while now. Please don't let the fear consume you! This is a crappy situation, but you have to brave the surgery if you have a fistula, it's really not going to heal otherwise. The surgery wadn't that bad, I only missed a couple of days of work and if you follow doctors orders you can manage the pain and healing. I wish you the best, but please don't be afraid, just get it taken care of and put this experience behind you!!
For me the surgery was surprisingly painless. I only had a hollow ache for the first two days after surgery and then nothing at all for the remainder of the 12 weeks it took to heal. How well you handle it I think is based on a number of factors- general health (e.g. are you one of the roughly 90% of fistula patients that don't have any underlying disease), cleanliness, age, diet, and, of course, the skill of your surgeon. I feel very thankful to my surgeon that the worst part of my recovery was the worrying that it might come back...the pain itself was virtually nonexistent. The other annoying thing was washing the area down after every bowel movement (and since I was eating 35-40g of fiber per day at the time, that meant 2-3 poops per day).
Thanks to you all for reading my question and answering. I am glad to hear that there are success stories, thanks.
I am constantly thinking about the problem I have and it is always there in my mind I have had a few nightmares about it too, lol!
It makes me not want to go out.
After antibiotics I'm still not happy about it and will be trying to get a GP appointment soon and hopefully fingers crossed get referred. I am NHS - the first time my abscess op was by a bowel surgeon but the second abscess surgey i had was by a general surgeon the 2nd op I had was not because of an abscess - it was because the outside of my wound healed and left a 5mm pocket under my skin and packing couldn't get in so they operated and made an even bigger incision though no infection was there...). I don't know if i can but i think i will ask for a bowel surgeon referral.
I am slim, don't have diabetes and i don't smoke or drink...
Thank you all for helping
I will be buying a cushion for sitting at work too
Thank-you Cporosus1 this is a very helpful answer.
I'm 1 month post-op and doing fairly well. I apparently had the fistula over 10 years. I thought it was an in-grown hair which wouldn't heal and flaired up about once every two months, resulting in me squeazing a little pus out. Well, in December of 2016 the little pus turned into a large abcess which totally freaked me out.
I bypassed a general practitioner and went right to a colon surgeon. He diagnosed me with an anal fistula. My sugery was scheduled for the end of January. In the mean time I went through 4 courses of anti-biotics to keep the infection at bay.
The morning of the surgery I also had an elective colonoscopy at the advise of the surgeon (I just turned 50 and never had one). Because the fistula did not pass the sphincter, into the rectum the Dr. was able to lay the fistula open.
I was off work a week. It was a week before I could sit for any time without a ring cushion. It was fairly painful for about two days. But after that I didn't have to take any pain medication. It drained chunky white discharge for about three weeks. After a month, I still have a little throbbing at time and some soreness. No infection though. I also have the urge to make a bowel movement, pretty much all the time. I'm hoping that will subside with more healing time.
Hello, how is it going?
This is one of the forums I visited during my ordeal and was able to register on. Here is my story I hope many of your find resourceful.
My issue began with what I thought was a hemorrhoid that kept bursting back in early February (it is now early April as I write this, so two months ago). I began feeling a friction time sensation in my peri-anal area that I attributed to the way in which I was sitting since the lump made sitting properly quite uncomfortable. I had also driven five hours.
Fast forward a few weeks later and the discomfort and flare ups were becoming unbearable. I finally headed to the urgent care where I was diagnosed with an abscess. The doctor there told me I would need surgery as that was too tender an area. He referred me to a dermatologist.
The dermatologist did the incision and drainage procedure and this helped relieve a lot of the pressure and discomfort but the blood and drainage continued, especially after a bowel movement. Flare ups were reduced but still occurring.
Urgent care had placed me on the wrong antibiotic, it was later determined after the dermatologist sent in the culture. I had an e-Coli infection as opposed to a Staph infection, which I was told tends to be worse and resistent to many antibiotics. I find it quite surprising that much of what I read on the Web suggests antibiotics are unnecessary when it comes to a peri-anal abscess. This is clearly an infection and requires an antibiotic. The correct antibiotic may have helped reduce the pus but by my third visit in just under two weeks the dermatologist felt the swelling and inflammation should have gone down completely by this time and sent me off to a rectal doctor and one more equipped to deal with a potential fistula.
I completely lucked out as the rectal doctor had an opening for that afternoon. He determined that the abscess had not been drained completely and proceeded to make a much larger slit with the incision and drainage. He also conducted a fistulotomy, not to be confused with the actual surgical procedure. This was a simple probe to determine the existence of a fistula. He told me it was a deep abscess and pressed to demonstrate the inner access point and the exterior access when the abscess had formed. At the time he noted a possible seton as the inflammation was too much to determine where the tunnel/channel crossed. This was not considered a complex fistula from what I could tell. This doctor happened to be my friend’s doctor and I was advised he had a very solid reputation. Was very nice and confident. Talked like he could do the procedure blind folded lol.
This was on Wednesday and my surgery was immediately scheduled for Monday. I was advised the surgery time would be from 9 am to 3 pm though the actual surgery would only take 15 to 30 minutes. Following this last incision and drainage I barely noticed the affected area and went about my normal routine though there was still minor swelling, some bleeding and pus present. Still, this was night and day compared to what I had previously been experiencing.
This would be my first surgery under anesthesia so was nervous going in and worried I might not be able to be put under (I do need sleep aids). Anesthesiologist assured me in her seven years of doing this only one person every experienced an allergic reaction and they have protocol to deal with that situation. Everyone assured me I would be knocked out and sure enough the moment they began hooking me up to the IVs I was out cold.
Next thing I remembered, it was about two hours later and the peri-anal area was sore and I woke up asking to use the bathroom. They gave me a container and I was able to pee no problem.
Within about 10 minutes I was brought off the bed and was able to sit (albeit wasn’t easy with the sore). I also inquired about any seton placement and told there was no mention of it in the datebase, so good news there. They gave me crackers and small containers of cranberry juice. It was important they were not discharging me until I could demonstrate I was able to urinate more. Once done with the juice I went into the bathroom and did just that. The nurse was happy with the result and preparing me for release BUT it is important you have someone pick you up.
I had already notified my friend and he was already on his way as the surgery and recovery time had pretty much gone as scheduled, concluding at 3 pm.
You need someone to drive you home. You have to be present at the pharmacy to get your pain killers as these are narcotics and the hospital cannot simply call in the prescription. I went to the pharmacy, showed my ID and my friend drove me home and went back to pick up the pain killers. I was nauseous and sore at this point (very uncomfortable sitting in the passenger seat).
Once home and once I finally received my pain killer, was admittedly in a pretty good mood having completed the surgery and feeling mostly soreness as opposed to actual pain. The stomach issues resolved pretty quickly (it appeared that the morphine had caused the stomach issues, probably coupled with the anesthesia. My rectal area was also tight and sore in addition to the external wound area, which seemed to have some type of plastic-feeling dressing. Not sure what it was as I didn’t feel much like exploring the area. I didn’t sleep great that night due to the soreness in both regions.
Day 1 after the surgery, in addition to the soreness, the other main discomfort was my dry throat courtesy of the tubes I was told had been placed down my throat.
By day’s end my whole body began to get sore. This came on relatively slowly. The surgical area on the outside was bleeding as expected but there was little in the way of anything other than red blood.
Day 2 after surgery my body was super sore all over to the point that I hardly paid any mind to the actual area that was operated on. The Oxycodone helped over this period but made me quite sleepy. On this day it was tough to get comfortable even laying down.
It was on this day that I also appeared to peel off whatever was covering the wound. This was the first pain I felt per se once the wound was exposed and I was unable to touch the wound without registering the sharp pain, that I would describe as “moderate” and close to a 6 on the scale of 1 to 10. It lasted no more than an hour with the exception of when I touched or rubbed against it.
Day 3 (Thursday) after the surgery my body soreness started to fade by the AM.
I hadn’t had a bowel movement yet and was worrying because inside my anus appeared to be stitched shut. I could feel what I thought was stitches but they actually turned out to be part of a big bandage I yanked out of my rectum. Had no idea it was in there. Lots of bleeding followed as did a very solid BM that caused zero pain (to my surprise). Take Metamucil and MiroLax as directed and keep in mind that the pain killers, while great, result in constipation. Lack of BMs I believe are a result of the anesthesia and its associated side effects. Despite the lack of cowel movements I did not feel constipated. It shoiuld be noted that I was doing little eating to this point following the surgery. Also, the bandage was causing the tightness inside my anal area.
With the bandage pulled out, the bleeding and the rather significant bowel movement I had felt mild throbbing soreness in that area the remainder of the day. Constant sitz baths helped. But I will say I slept like a baby this night with no serious soreness felt unless I happened to rub against the wound.
Day 4 (Friday) decided to take local drive to do some grocery shopping. The wound area was still sore but really only when sitting or rubbing against it. I was not very comfortable driving at this point but it was bearable. This was due to the pressure placed upon the wound. It was the first time sitting since the day of the surgery. I had also cut the pain killers down to one this day and that was before bed.
Day 5 (Saturday) went out for lunch and continued feeling better. Again, it was just when I sat and applied the pressure that the wound area caused any discomfort. Unlike when I had the abscess, the area did not experience continued inflammation.
I am wearing the feminine wing pads and they are fantastic in dealing with this. While I have the bleeding still, it’s leaving minimal stains on the pads compared to before. I am leaving a piece of cotton in my rectal area as that continues to bleed as well.
I have had four BMs since this day with the last one an hour ago from when I was writing this. The stools even passed over the open wound. Really anticipated some type of flare up but nothing as of yet. I immediately jump in the shower and the bath as it is important to keep the area clean.
I’m fortunate enough to work from home and have done so laying in bed and applying the least amount of pressure on the surgical area. I will occasionally work while laying on my stomach. I could not see myself venturing to an office job the first four days after surgery and certainly no jobs requiring strenuous activities. By Day 5, I could probably have returned to work with some degree of confidence. Just make sure to have an adequate amount of dressings and a pad in place. I also like the thin cotton ovals to place along the wound area.
The healing process I know will likely take three months or more so I’m not gonna fool myself and believe there won’t be any setbacks. The wound is wide open and about the size of a quarter. It’s still bleeding with very little evidence of pus.
My follow up was scheduled for approximately 3.5 weeks after the surgery.
Thanks for all the information.
As as far as antibiotics go they say they do not necessarily work due to were the abscess is, there is not enough blood flow to that area to carry the antibiotic so that can be why sometimes they don't work. They didn't work for me.
I read recently on this forum that applying magnesium paste to the abscess can help but that doesn't stop the underlying reason the Abscess formed in the first place and if you do not address that it is likely to come back.
My story is on the perianal Abscess organisation website. It also goes on to talk about how diet can help you avoid this happening in the first place or healing it once you have it and it is interesting to see a few people here on the forum saying the same thing. Everyone is different though.
Good luck with the the healing process thankyou for this very detailed, honest, how it is account of what you went through. Good luck with the healing process.
In all likelihood this is true what you are saying about antibiotics. Having been on the correct one for more than two weeks based on the culture sample, I was just advised last week that at the time of the operation the area was still very much infected and inflamed. So basically it would appear that the antibiotic did little or nothing to resolve this issue.
Week 3 went for my follow up and told it was healing really nicely. The mild discharge (light yellow) and occasional blood has been continuous and I was advised this is very much normal and expected (emphasis is on the mild).
Also once I was into Week 3 I noticed that the soreness at the touch of the open wound (whether it be when sitting, maneuvering to get up, walking long distance with some rubbing, or physically touching) had been reduced significantly. Especially when sleeping and repositioning in bed, this soreness was most evident the first three weeks. It was nothing that required any type of pain medication, just something to remind me that there was a wound there. It was enough to wake me up a few times over the course of the night.
Now into Week Four there are times I am not even concious that I had the surgery. Touching the wound it's hardly sore and feels more filled in. I still have the mild discharge and the occasional blood. I use a piece of gauze and continue to wear the pad. The guaze keeps anything from getting on the pad. For me it is just that extra feeling of protection.
I've traveled by air in the past week and felt fine during my travels out of town.
I was told two more weeks and should be healed. My doctor has scheduled another appointment in a month specifically to discuss diet changes and ways to prevent the abscess from returning. He did indeed emphasize the impact of diet though that will be discussed in more detail at my next appointment.
Fantastic news, that's so good to hear. Thankyou so much for this detailed answer. Great to hear of a doctor who is advising diet as a way to help manage this condition, I wish my consultant had been the same! Anyway keep up the good work, hoping you will not need to use this forum again 
Thanks again.
Hi fistula1968. Thanks for ur success story. I hope to be cured one day too. If I may ask, what was the size of ur abscess when you first had it?
Hi just to let you know my surgery has been a success so far.
Around 2012 I had a really bad peri anal abscess which resulted in a 6cmx6cm cavity after emergency surgery! Safe to say that wasn't how I wanted to spend my early twenties!
It never seemed to heel properly and forever drained yucky stuff. I queried a fistula however my dr was adamant there was nothing wrong.
Around a year later another abscess appeared I was mortified and had to get rushed in for further emergency surgery to get it drained.
Following this I had an MRI which confirmed my original query of a fistula!
A good few months later I was put in to surgery for my peri anal seton to be fitted.
In all honesty the pain was very bad to begin with and going to the toilet brought me to tears but with a lot of pain killers and rest it did get easier!
I dreaded the thought of having to go back in to surgery to have it tightened because of the pain!
Not only the pain but the embarrassment of finding a partner and explaining the bright blue plastic in the most random area!
A year later I was due to go back to surgery to have it tightened or they were going to cut the final bit of skin depending on how far the seton had cut.
If I'm honest I forgot that it was there and after a while there was no pain!
A few days before my surgery I went to the loo and it fell out. My consultant checked it over and said the seton had done its job and was happy with its success!
2 years on and I have had no issues with any abscesses etc which I'm hoping continues because the pain and agrication of it all is stressful so I really feel for you!
So fingers crossed things go well for you!!!
All, Currently scheduled for surgery on Friday. Nervous but know that the constant discomfort I have been experiencing will hopefully be coming to a close. Will let you all know how it goes. Thanks for the detailed posts and sharing of your experiences. Gives me something to discuss with my surgeon and am a little more realistic as to post operative expectations on pain and work etc.
Good luck, hope you are well soon.
I need some advise . My journey began like many of yours . In June 2017 I found a lump in the muscle on the left side next to my anus. It was hard and hurt when pressing on it. I should mention that I'm an equestrian and have a horse farm. I ride horses every day of my life . I was told that this was probrobly a bruise from riding from the first two Drs that I saw . By the third they did a CTscan and found a small perianal abcess . Within days I had surgery. June 23th as a matter of fact. They put a wick in and I had to remove it within 24 hours. That was awful to say the least. Now 8 weeks later and I still have drainage . A 2-4 week healing time is now at 8 weeks. I was at the Dr weekly asking why is it not healing. I was eating VERy healthy! Lots and lots of greens, fiber, probiotics , and tons of water . He couldn't give me answers. Now I should also mention that I do my sits and have been very consistent every day with it. At least 4 times a day . And ALWAYs after a bowl movement . I have not been diagnosed with any bowl or GI disorders. I'm a health active young 33 year old that I should also mention that I'm getting married in 6 weeks! Lots of stess to be dealing with and the worriy of why this is not healing . Finally I went to a bigger and better hospital to see a colon rectal surgan who is supposed to be the best . She took one look at my MRI and said I have a small fistula . I'm freaking out ! I mm so afraid of the surgery because of all the terrible things I have read! I'm trying to hold off until after the wedding . I'm scared of having to now deal with this for the rest of my life and just starting out my life with my new husband I'm worried that this condition will change my life forever . Any advise or reassurance I can't get would be great!! Please help!!!