Hello all fellow fistula sufferers!

This is my first post on the forum but I have been a long time reader since battling an anal fissure since Dec 11, having LIS then ending up with a superficial fistula. Fun times.

My question is, if anyone has any similar experience, is as follows. I had a laying open of a superficial fistula in May of this year. Healing was slow and painful. I'd basically got it healed from the inside of my rectum to the anal verge, which was still sore and open, similar to an anal fissure in a way. However, and very unfortunaely, I took some painkillers for headaches which constipated me, resulting in some damage. This was three weeks ago and things now feel much the same way as when I left hospital in May. Bummer (No pun intended..)

I went to see my surgeon yesterday who examined me and advised that it was chronically inflamed and there was a build up of granulation tissue at the fistula site. If this hasn't resolved itself in 6 weeks then its back in for this to be scraped out. Not looking forward to this as recovery the first time was slow and painful!

I was just wondering if anyone has had this scrape, or had a setback and healed again during recovery?

Thanks. : )

Oh Asstronaut,
Sorry to read of this - I just found your post.
Unfortunately, it does sometimes happen during recovery to some and although some inflammation is normal, infection or further physical damage can make this process worse leading to the chronic state such as you describe.
Have you been treated with any medications for this?? I can imagine it must be really sore to deal with - Are you using ice-packs to help numb the pain?
I suspect all you can do is keep the area clean & dry and ensure you move around a lot to take excessive pressure off the area........and then of course just wait up and see what happens....
I wish you all the very best with this and hope that the situation does resolve itself naturally for you with time....Keep updating!.......

Hi Ever the Optimist,

Thanks for your message. I am still waiting up, pain levels have reduced some and it doesn't feel so open and raw, but it's still not showing signs of moving towards complete healing which means I may be going back for further treatment in a few weeks if things don't improve.

My CRS said exactly the same, clean and dry is key. Unfortunately I've over done it so much on the GTN and Dilt that I'm super sensitive to it now to the point where I break out in extreme itching, as many seem to report.

It's a funny old game this healing process, I was under the false illusion that as I'd already had LIS that I'd heal no problem. Guess again!

Cheers

Hi Asstronaut, if you are sensitive to dilt and nitro, you can try nifedipine. It's in the same family as dilt, but different enough that your skin may tolerate it better.
Also try the good ol' heat treatment. It feels very nice, and is healing too. Sit on a very warm hot water bottle or heat pad.
Sorry you are still in pain. Keep us updated!

Hi Scientist,

Good to hear from you again. Unfortunately we don't get Nifedipine in the UK, which is a major bummer (no pun ; )). I tried for ages to get hold of some only to be told by my CRS it's US drug.

I will give the hot water bottle a try. I was wondering if you could recommend any heating pads for the car etc? May need this with the winter coming up.

Not looking forward to more surgery, post LIS I was enthusiastic in hope for a cure, but three operations later and the recovery phase is wearing thin!

I'll keep posting my updates! : )

Has your doctor recommended silver nitrate applications? I am healing from my third fistula related surgery and they're currently using silver nitrate to get rid of the "hyper granulated" tissue. It literally burns away the bad tissue and promotes healing. It's very painful when applied but the pain subsides after a few minutes and it usually settles down within 24 hours.

Hi Diamond,

I have been doing some reading about silver nitrate actually and have made a note to speak to my CRS about it during my next appointment. From what I have read it sounds like it could be for me so I'm quite enthusiastic.

How do they apply it? Is it done under a GA? I'm just trying to picture it, as my wound is hyper granulating inside my anal canal which would be tricky to get to without GA I should imagine.

Thanks.

It burns! Before my Seton placement I was having nitrate applications on a stick and was pushed thru the opening that I felt was not healing. They had me lay on my side knees bent and pushed in as far as they could go. I wish it would've worked for me. But ended up failing.

Given that it's inside your anal canal I'm not sure how they will apply it. My wound is right now pretty much a surface wound so it's easy for them to apply the silver - and yes it burns like a b*tch! I usually have to get in a weird position on my side and hold one leg up and pull apart my "cheeks" for them to be able to get in there. My home nurse applies it every 3 days right now, no GA - but really not sure what they would recommend given your specific issue. Definitely ask your CRS!

When I still had depth to the wound I had daily packing in there. Initially it was just packing ribbon soaked in saline, then they started using a dressing called MeSalt which really helps clean up the wound and promotes healing. Next, they were looking at using a dressing which has silver nitrate infused in it next (I don't remember the name - will ask my nurse) - but at that point I had no depth left so they opted for the silver nitrate sticks. I wonder if maybe they can use the infused packing on you? It is painful to put the packing in and take it out depending on the depth but I think packing is essential to ensure you heal properly. How deep is your wound?

Found it! It's called aquacel http://www.convatec.com/wound-skin/aqua ... gical.aspx. If you do have a wound with depth to it, I don't see why they wouldn't try this and as it continues to close they can then switch to the silver nitrate sticks. The sticks literally burn off the "bad" tissue and ensure as you heal only "good" tissue is left behind layer by layer.
Let me know if you have any more questions.. I've been dealing with the silver applications for a number of weeks now :) Just had one this morning!