Do I have a fistula? How is surgery going to be like?

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Do I have a fistula? How is surgery going to be like?

Postby owieher » 16 Jul 2012, 22:10

Hello,
I'm new to this board, but through google, found out that this forum is more geared and active towards anal fissures and the works.
I've had my 1st anal abscess 4 months ago. Since then, I've been extremely sensitive of the area, and every little detail, or discomfort. Since then, I've had a few fissures here and there which has caused me some concern. They did clear up after 1-2 weeks. The openings would close and I thought this was a fissure.
But recently, I noticed the area 'felt' like it wanted to form a pimple and eventually another opening came about, but it was at my surgery location. I've looked through google and all that and the pictures between a fissure & fistula are kind of difficult to distinguish.
What type of specialist should I see, and how is the diagnosis or determination going to be like? More so, how is the surgery process.. I'm so scared and frantic.
What if this opening closes itself again? Would this be a fistula, or just a fissure that happened to tear near the area of surgery?
Thanks.
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Re: Do I have a fistula? How is surgery going to be like?

Postby AFalumni » 17 Jul 2012, 09:21

I am 2 weeks post fistula surgery. All I can do is tell you what happened to me. I had a fissure appear in March. Massive pain that caused me to see a colo-rectal guy (CRS). He diagnosed the fissure, gave me, nitroglycerin, and started me on fiber and water. After weeks and months, it began to heal itself. Whew...I thought...
Then, in June, I had an abscess burst and the pain sent me right back to the dr. (I didn't know it was an abscess at the time). He diagnosed it as a fistula and said he was sorry, but they never heal on their own. We set the surgery for a week later. I was scared, but he assured me it is the easiest and simplest thing he does. Basically they open up and lay flat the fistula which then allows healing occur from the inside out.
The surgery went great (he also went ahead and did a Fissurectomy at the same time to "help the fissure along". I haven't felt this good since March. I am SO glad I had the procedure and highly recommend it!
At my post-op exam, he said all was well and I would be fully healed in 4 weeks.
I hope this helps!
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Re: Do I have a fistula? How is surgery going to be like?

Postby owieher » 17 Jul 2012, 14:54

^ Hi,
Do you know how long the procedure was like, and how the examination was like w/ the colorectal specialist?
I'm trying to find a colon/rectal surgeon and I just want to know how they would diagnose my situation. Do I have a fissure from a previous wound, or do I simply have a fistula that needs surgery?
I'm so scared, I don't know where to begin.
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Re: Do I have a fistula? How is surgery going to be like?

Postby thisfissurecankissmybutt » 17 Jul 2012, 15:37

You are on the right track by looking for a colorectal surgeon (CRS) as you definitely want to go to a doctor that deals with these kinds of issues all day, every day.
At your appointment, the CRS will do an examination. They can often make a diagnosis by inspecting your anus visually; however, the doctor may have to use a small scope to get a better look. If you are too uncomfortable for an examination, your CRS may recommend an examination under anesthesia (EUA). This will allow your CRS to get a close-up view of the affected area.
There are many things that could cause a fistula - a fissure that heals incorrectly, a previous cyst that bursts, a previous absess, etc.
In most cases, a fistula will require surgery to completely remove the fistula. The extent of the surgery will depend on the extent of the fistula. Some fistula's are superficial -meaning they don't connect to anything - and these are the easiest to remove surgically.
If you have a fissure, your CRS will likely start by trying conservative measures (i.e., prescription medication like Nifedine or Diltiazem, fiber supplements, lots of water, hot baths, etc.). Conservative measures work about 75% of the time (according to my CRS). If they don't work, you may want to have surgery which will allow the sphincter muscle to relax so the fissure can heal properly.
Once your CRS has determined exactly what you have, you can begin to discuss your options.
I know it can be scary, but one of the great things about this forum is knowing that you won't be going through it alone. There is a whole community of fellow sufferers who are here to help in any way we can.
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Re: Do I have a fistula? How is surgery going to be like?

Postby owieher » 17 Jul 2012, 20:40

I think finding a good doctor/surgeon is the challenging thing. I'm going to call and see if I can get an examination.
The opening is about .4CM, and I don't feel any pain from bowel movements or what not. Only if I clean the area w/ water do I feel slight stinging. However, I am pretty darn sure that the opening closed a few weeks back. It's odd to see it open up again.
I'll update. I appreciate the support and help. It really does make a difference in talking things out.
I'm very scared actually, and have never been operated like this.
Thanks.
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Re: Do I have a fistula? How is surgery going to be like?

Postby AFalumni » 17 Jul 2012, 21:47

The actual surgery for laying open a fistula is very short (less than 15 min.). It's apparently one of the simplest procedures they do.
I found my CRS by asking my regular doctor for a referral, then I checked online for reviews. I have been very pleased.
You will feel much better after a consult with a CRS. As far as being scared to have surgery on your anus, I totally get it. I was terrified, but it was much better/easier than I thought it would be. I am so glad I did it!!
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Re: Do I have a fistula? How is surgery going to be like?

Postby owieher » 18 Jul 2012, 22:09

Well folks. I managed to find a good CRS and have made an appointment. The thing is, it won't be until August 1st.
I'm going to worry, but what if this opening closes by itself? Would the scans and examination be possible to detect a fistula?
Thanks
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Re: Do I have a fistula? How is surgery going to be like?

Postby AFalumni » 19 Jul 2012, 08:01

Apparently, if it's a fistula it will not close on its own. That's why surgery is the only option for a fistula. (are you seeping a bit of yellowish discharge? I did with my fistula.). If it's a fissure, it may start to heal on its own. In any event, I'm so glad you made an appt. I know it will be a long wait until the 1st. Drink lots of water (at least 64 oz., eat a high fiber diet, and take 3-4 warm (not hot) baths a day. It will help.
Keep us posted with your progress!
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Re: Do I have a fistula? How is surgery going to be like?

Postby owieher » 19 Jul 2012, 21:15

AFalumni wrote:Apparently, if it's a fistula it will not close on its own. That's why surgery is the only option for a fistula. (are you seeping a bit of yellowish discharge? I did with my fistula.). If it's a fissure, it may start to heal on its own. In any event, I'm so glad you made an appt. I know it will be a long wait until the 1st. Drink lots of water (at least 64 oz., eat a high fiber diet, and take 3-4 warm (not hot) baths a day. It will help.
Keep us posted with your progress!

The opening is the same spot as the incision I had for the abscess a few months ago. Thanks for the tips.
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Re: Do I have a fistula? How is surgery going to be like?

Postby zowie » 20 Jul 2012, 12:40

My CRS just examined me a couple days ago and thinks I have a fistula. He wants to do an exam under anesthesia to know for sure. He had me sign permission to do a "seton" procedure at the same time if I need it. He said it was something like a rubber band he puts around the fistula? I don't really understand much. He said if it is a fistula he will do a "anal advancement flap" which again the more I read the more scared I get. This is not like a major thing to me.... so I'm not sure why such aggressive treatment. I'm trying to decide what to do :(
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