I am 47 and female and I have been dealing with a fistula now since February, and this website has provided me endless support, hope, and, more importantly, the realization I was not alone and not such a freak, so I just want to give back in whatever way I can.

First I had a fissure about a year ago. I went to a colorectal surgeon, and after discussing options, I chose not to do anything about it. I used prescription suppositories and nitroglycerin ointment (spelling?) when it flared up. I also did not try very hard to address my chronic constipation issues. Is that what caused my subsequent abscess in February of this year? I don't know. But supposedly severe constipation and steroid use (which I think is in the suppositories) are noted as possible causes of an anal abscess.

I went to the hospital February 11 and told them I was pretty sure I had an anal abscess due to my online research. The doctor I had seen that day (not my regular doctor) said, "It couldn't be an abscess because the pain does not ebb and flow, but rather increases steadily." Well, two days later in the emergency room due to my husband's absolute insistence I go back to the doctor, it was diagnosed as, indeed, an anal abscess. The surgeon on call tried to lance and drain it without anesthesia but it was too deep, (that was a 10 on the pain scale!!!) so he bandaged it and had to wait four hours until it was safe enough for me to have "saddle block" anesthesia, since I had eaten dinner about one hour before going in that evening.

I was very worried I would flinch when the anesthesiologist gave me the shot in the spine! But it went very smoothly, no pain at all with the shot, and although I was awake for the procedure, I do not really remember it and have absolutely no memory of pain. Actually, I just remember feeling incredible relief! I went home and immediately started reading up on abscesses on this website and other online resources.

That is when I realized it may not be over for me, since there is a 46-50 percent chance of a fistula. Even though I was crying my eyes out that it may not be over, I am so glad I knew of this possibility because it gave me a chance to come to terms with what may be -- and was! When I could see that it was not completely healing, I knew right away what was going on. So I scheduled an appointment with the same colorectal surgeon whom I had seen for my fissure, and of course it was confirmed that I had a fistula. He explained the options and scheduled me for an exploratory surgery so we could decide what to do.

I had an anterior anal fistula, and since I am a woman, that makes it automatically complex. I read that somewhere, but I cannot remember why it is complex simply because it is anterior. It was low, however, luckily for me. A draining/loose seton was placed, and my doctor explained the different options. I was to wait two months to see if the draining would subside and he could make a more informed decision then. I was terrified of the pain that the "satan" seton would cause me. I am a court reporter and it is pretty hard to mask discomfort when you are sitting there in the middle of the courtroom, and I cannot just get up and leave! Actually, I think this fear is what exacerbated my constipation to begin with. I was too worried and trying to control my body in every way. I wouldn't let "nature take its course."

I knew I HAD TO ADDRESS THE CONSTIPATION problems that I have dealt with since I was about 8. When I was 22 I had a sigmoidoscopy and a colonoscopy to see if I had IBS or what the problem may be, but there was no diagnosis, so I contined on as usual.

I am happy to report for the last four months, I am now as regular as anyone!! I tried so many different suggestions from the internet, but the things that work like a charm for me are: 1) Two small glasses of water first thing in the morning, before my cup of coffee, a bowl of Fiber One cereal, the one that looks like twigs, with some berries and half a banana (but I don't have to have fruit, it just tastes better) and a half glass of prune juice in the evening. If I need more or less help, I will drink more or less of the prune juice!! And last but not least, a much more relaxed and healthy attitude about BMs!

Luckily for me, I had very little pain after the placing of the seton. I was out of work for four days and came home at lunch time to take sitz baths for two weeks. The first BM after this surgery was scary, but it wasn't so bad.. And I had no pain from day three on. The seton was somewhat annoying, but that was it. No pain, but it was hard to feel clean and girly with the constant draining, and I was always worried that I might smell. I felt like I had a sad secret, and when people asked what was going on, you certainly cannot tell them!!

That is another reason why I thank you all for this website! I could just read for hours and get comfort and strength from everyone's stories. Oh, and I did an online search to see if I could swim in the ocean with a seton but could not find anything specific. I asked my doctor, he said sure. I went snorkeling five times and was in the ocean every day for a week. It was a little sore, probably from rubbing against my swimsuit, but no problems at all.

I just went in for my third surgery yesterday, July 10. (third in six months) The plan of attack was a Flap advancement surgery with the slight possibility of a fistulotomy. If this flad advancement did not work, we would place another seton and try the flap again.

I was so excited and relieved to wake up to the news that he was able to do the fistulotomy!! He said setons occasionally can make it easier to do a fistulotomy later on, and in my case, that is exactly what happened! I asked about incontinence, and he said he does not think that will be an issue because he did not have to cut through any sphincter muscle?! I did not think that was even possible! So right now I am just over the moon elated!! But I will keep you posted on the progress. Oh, and this surgery hurt the least! On a scale of 1 to 10, I would put it at less than 1 as far as pain goes. Really, the only one that really hurt was the abscess D&C. I have not had to take even one Norco that was prescribed. And, like last time, I was worried about the first BM. No pain and no problem!!! But I do still have to do the 3 to 5 sitz baths a day until fully healed, which should be approximately two weeks.

Anyway, I just wanted to post my story here to give back to all of you who are so brave in telling your stories and concerns and torments!! Thanks to all of you I was able to handle this extremely difficult chapter in my life without completely "losing it."! And I know I may not be done; there may be more to deal with, but I will again turn to you all for continued comfort and understanding!! THANK YOU FROM THE BOTTOM OF MY HEART!!

By the way, here are some websites I also liked for information: http://www.wjgnet.com/1007-9327/full/v17/i28/3292.htm. and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160530/

And an interesting supposed new method of treating fistulas that I could find very little information on, but is worth watching out for maybe: http://medizin.pr-gateway.de/filac-lase ... n-germany/

HI kroert95.... so glad to hear that you are a road to putting all this behind you ... Im a 37yr female with a similar story anal abscess drained turned fistula.. then fistulotomy & seton done and now seems all is good .... I have to agree with you 100% about this site ... I thought i was going crazy being alone with it all but this site did wonders for me .. I also did research after i had the drainage done as i was told in the ER that i was gonna get a fistula so that made me want to know everything i could about this and it made me more prepared when i got the offical diagnose of it being a fistula now.. I had my surgery on Dec 10/14 and the seton was removed on Jan 23 and everything has since slowly come back to what i now know as normal ... my only issue now is that i have reclean about 20 min after a BM but if thats what i am left with after all this I am totally cool with that ... well I also now have a scar that my hubby says reminds him of a grin on my butt cheek .... I was the opposite to you with my BM before all this happened .. I had IBS and would go to the bathroom anywheres from 2-5 times a day but now i call my self a poop natzie as i make sure i eat my meals same time each day drink 8 glasses of water each day and eat probiotic yogurt everyday just so i stay regular and the stool stays soft and free flowing ... Keep your chin up your on the right path and let us know how things go for you ... :)

Hi K,
Thanks for sharing what you've been going through. I flinched when i read the doctor tried to lance the abscess with no anaesthetic - what?!?! I'm glad things have progressed well for you. AA

Your story sounds a bit like mine- enough to make me worry (even more) that I have a fistula. Can I ask a naive question? How did you know you had an anal abscess? What were your symptoms? I'm well versed in the world of anal fissures (a dubious honor), and I'm also well versed with abscesses in the groin area (I have hidradenitis supparativa). Was your anal abscess an internal or external abscess?

Also: anterior. What does that mean? Anything I find on that just gives me a diagram of a rectum, which I cannot decipher. Is anterior in the perineal area?

Hi Ceetee ... they said my abscess was perianal abscess ... what exactly that meant not sure but they said one of my anal glands became blocked and filled with puss not being able to release it with BM which created the tennis size ball i could feel in my butt cheek... BM's were a lil difficult as you could imagine trying to pass stool past a abscess that size ... my hubby said he could see a reddish round area on my cheek also and so did the doc ... I also had fever and sweats while i had the abscess... Im also a diabetic and my sugars where a lil higher then I was used to as i had the "infected" abscess in me ... hope this info helps :)

Hi Ceetee, I had a constant throbbing pain that just absolutely would not go away!! Sometimes it took over and I just laid there waiting for it to subside, and others it was just a low throb. I had those symptoms probably almost two weeks total, week and a half. When I finally was diagnosed in the ER, the doctor said, "You should have come in earlier."!!! I did!!! And I was told I probably had a cyst and not an abscess because I wouldn't have been able to bear it. The doctor in the ER said if a person has a really strong immune system, the infection can get worse, then subside, get worse.... as your body tries to rid itself. Anyway, if you suspect you have an abscess DO NOT HESITATE TO GO TO THE DOCTOR!! If I had it drained sooner, perhaps I would not have developed a fistula? I have a male friend who had a perianal abscess in his mid 30's, and he did not have a fistula afterwards. Probably just luck, but why push it? "Anterior" is what my doctor called the location of my fistula. I am pretty sure it means the portion closer to a woman's vagina is anterior. I will try to find a diagram I found while searching the web that would explain it. But I still do not know why the anterior on a woman automatically makes it "complex." I am pretty sure it was explained in this website too. Here is a picture, albeit not very good, of the "anterior" reference I was talking about. http://img.medscape.com/pi/emed/ckb/gen ... 1610tn.jpg and http://emedicine.medscape.com/article/1 ... #aw2aab6b4. Also, if you can handle the gore, there are quite a few videos online on youtube that actually show fistula surgeries! I had to wait until I could deal with that. Sometimes it is better to watch them after your surgery so you know what you went through and you know better how to care for yourself, if that makes sense. It actually helped me, but it CERTAINLY is not for everyone. Hope this helps.

Oh, and I promised to update, just so others can gauge the possible recuperation time. Unfortunately, I spoke too soon when I said I had very little pain. I am experiencing some pain now, especially after some BMs, but not all of them. Go figure! It is strange that I would feel almost zero pain the first two days, and then the third day it shows up. All I can guess is that the wound is healing now and BMs stretch the skin and causes the burning sensation. It has not hurt bad enough to take the Norcos, which I really hate taking because they make me grouchy and depressed. But I did take an Aleve one night, and the sitz baths do help take away the sting after a few minutes. Oh, well.

Just to update, today the pain is much more manageable. I think the key is the baths!! I think it keeps the skin more moist, so the skin doesn't rip as much in the case of a sudden cough, sneeze or BM. More tender today than pain, really. I went for a three mile walk with very little trouble, other than I am out of shape in general lately. I am planning to return to work full days starting Monday, coming home at lunch for baths, which is absolutely critical, I think. So I had my surgery last Thursday morning and will return to work this upcoming Monday. I am posting this for anyone who wants and idea of what maybe they can expect after fistulotomy surgery for low superficial fistula. Strangely, I don't think it was superficial at first, five months ago, but now it is? But I don't understand how it could have changed.