Hi everyone, Im a 42 yr old male in the UK. Ive been diagnosed with a Low Fistula and am booked in for surgery on 22nd January as a day case with BUPA, where it will be removed and layed open. Ive just been for my preop and to say I am apprehensive is an understatement, but I know it must be done. I do not have Crones and the reason for the fistula was as a result of surgery I had when I was 22. All these years I thought it was piles. Any advice would be much appreciated.

hi peelie
im recovering from a fistulotomy ,this is the op you are having ,mine was a little higher than yours mine went through some internal sphincter muscle ans a couple of fibres of external sphnicter muscle,my fistula was a reult of an abscess which formed ,somi has 2 ops one to drain the abscess and install a seton which kept the fistula track open to drain the abscess and when that was ok i had the fistulotomy to lay open the fistula ,all went ok healing ok i get a achy pain feeling in the area ,i think its where he cut the muslcle and nerves all comming back ,keep your diet soft ,not hard foods ,cut down on cheese and red meat ,and cafeen ,drink loads of water,i also take movicol a stool sofner,
i clean up after a bm with warm water wetwipes ,and shower head ,and for the fisrst 3 weeks i also sat in the bidet with nice warm water ,
as yours is a low fistula it might not touch the muscles ,so will br a simple lay open a small wound if you have no abcess ect,
also get your doctors nurse to ckeck it out once a week to make sure it heals from the bottom up
good luck

Hi Peelie - Sorry to hear you're going through this as well. I had two fistulotomies done about 3 months ago. One was pretty high so I still have a seton in it. I am most likely going to need the LIFT procedure - I'm just buying some time to see what'll happen. I would say that the hardest part is the first week of recovery.
If you're prescribed pain killers post surgery - take them! I tried to be "brave" and didn't take them - until I really realized what pain was during my packing change. If you're taking any strong painkillers that can be constipating, please make sure you are taking both stool softeners and a laxative. I was on percocet and managed to get very badly constipated on day 4. The pain from the constipation was the worst thing I've ever experienced.
As Richi said - make sure you keep your diet healthy, drink lots of water (I think I was drinking 10+ glasses a day after the constipation episode), avoid any constipating foods, keep the area clean. I took sitz baths with epsom salts several times a day. If you don't have one - purchase a hand held shower! It was a life saver for me.. I haven't used any soap in the area ever since surgery either - I just wash it really well with the shower. I washed the area after every BM. In terms of diet - I ate lots of apples, veggies, fish, chicken. I also took vitamin C and zinc supplements for a few weeks post-surgery.
Depending on how deep the wound is, you may have packing. One of mine was very deep - about 3.5cm so I had a long packing strip in there that had to be changed daily. As your fistula is low, hopefully you don't have to go through all that. Overall, stay positive :) Let me know if you have any additional questions!

Thanks Richi and Diamond. Luckily for me my consultant says it is low so therefore wont need packing, my surgery is a day case so in and out the same day. Ive managed to get 2 weeks off work but am quite worried about the recovery afterwards as I know its going to be painful. Ive bought a ring to sit on and a bidet to use warm water to clean myself after a BM, im also going to go in the shower to clean up I think afterwards as well. Ive put this off since September last year and know I cannot put it off anymore, plus I hate having to drain the fistula every few days, so hopefully in a week or so it will be gone. Thank you both for your advice.

Ok, here goes, had the surgery earlier on yesterday adternoon 3pm, its now 12.45am and all i can say is it feels like someone has a red hot poker up my ass, the pain is immense, but the local anaesthetic used on the area will have worn off so im now taking paracetamol 500mg and one ibuprofen 400mg. Please tell me the pain will ease? Also i have a packing inserted in my rectum that the surgeon said will shrink and dislodge by itself or when i have a BM. During surgery they removed and lay open a low fissure fistula and removed a pollip ( what the surgeon called it) the procedure took 20 mins and i was great when i came back with no pain, oh what a false sense of security i was lulled into . Oh well 9 hrs post op, i just hope it gets a lot easier.

peelie,
yes, the pain IS going to diminish. Your doctor is really going rather light on the pain medicines with you. Unless there is some medical reason for that related specifically to your case, you really ought to have something stronger than you've been taking. I would encourage you to make a phone call and get something stronger on board to cope with this initial days after your surgery. As Diamond suggests, you will have to beware of constipation with stronger painkillers, and you will want to add a laxative/stool softener, which your doctor should advise you about as well.
Wishing you a speedy healing and recovery.

I know nothing about fistulas but what I do know is anal surgery is the pits! I've had 5.... Anyway, (I'm not a dr, btw) I would suggest taking the pain meds 15 mins or so before the rx time. That way it's in your system before the last dose wears off. Do sitz baths (if youre allowed-again, not sure about the fistulas) as often as you can tolerate them. You can try ice down there too but I will say it didnt help me for my fissurectomy with LIS. It seemed to exasserabate my discomfort. But everyone's different so give it a shot. Also, I LOVE NyQuil. I take it often at night to help with aches and pains and, obviously, to sleep. What I do is make my 11pm dose the NyQuil instead of the narcotic and take the NSAID with it. You don't want to mix the narcotic and the NyQuil cuz it's too much acetaminophen. Now, with everything your taking for pain you must remember to take the stool softeners, laxatives etc and drink as much water as you can imagine. I'd also recommend laying off red meat for the next month cuz it's crazy hard to digest and you risk it coming out like a brick instead if like soft serve Hope all that helps!

Wait! I just looked up "paracetamol" and it seems to me that its just pain old Tylenol. No narcotic. Good grief!!! I'd be climbing the walls! I agree with jr2, you should ask you dr for something a bit stronger for at least a week. Good Luck!!!