Hi Ritz,

It depends on the kind of fistula and the health of the patient. From all the peer-reviewed scientific articles I have read, it seems the vast majority of healthy people who have a fistulotomy for a low, non-complex perianal fistula do not have a recurrence. Most studies show that for this group successful surgery (no recurrence) is 90%+. I had a fistulotomy 12 weeks ago and it is basically fully healed (there is still some redness and perhaps a tiny open spot near the rectum, but I reckon in another week or so it will be fully healed). My uncle had a fistula in 2012 and required a seton (I do not know the exact circumstances as he has not shared them and his treatment was done through the V.A.), and after two operations in 2012 he experienced no more problems with it (been nearly 3 years now). If you have Crohn's disease obviously the chance of recurrence and more complex fistulas is much higher, but that's a whole different story entirely. Basically the point to get across is this- don't let the myriad of horror stories online freak you out and keep in mind two things- 1.) Most people (90%+) who have a simple fistulotomy for a simple fistula do not have a recurrence and 2.) People who successfully recover from fistula are FAR less likely to post online and tell their story than people who are having recurring problems. Those 90% likely move on and don't bother with message boards (hence the wealth of horror stories and drought of success stories). Either way- hang in there, even in the worst case scenarios fistulas do not last forever.

Also, as far as wound healing goes...every person heals differently but you can do some things to help encourage it. I've found that taking a multivitamin and eating a healthy diet rich in lean protein is great. Keep active too....exercise will help get circulation to the wound and will also help your mental health while coping with the wound. My surgeon gave me the green light to return to heavy power-lifting/weight lifting a mere two weeks after my fistulotomy, so I'd think pretty much anything with the exception of swimming (due to the bacteria in the water) would be allowed (although you still should check with your surgeon to make sure).

Cporosus1 wrote:Basically the point to get across is this- don't let the myriad of horror stories online freak you out and keep in mind two things- 1.) Most people (90%+) who have a simple fistulotomy for a simple fistula do not have a recurrence and 2.) People who successfully recover from fistula are FAR less likely to post online and tell their story than people who are having recurring problems. Those 90% likely move on and don't bother with message boards (hence the wealth of horror stories and drought of success stories).

This should be copied and pasted at the top of the forum as a disclaimer, it is 100% true and very important for people to realize.

I scared the crap out of myself by reading forums like this. I didn't think I was going to be able to sit for a month, because so many people said how long it took before they could sit. I thought I would be in constant pain, in agony. I thought I would have this huge gaping wound that needed a nurse to pack with gauze. I thought I would have a seton (or two, or three!) inside my butt for years like some people have complained about. Etc. etc. etc.

The reality? I never had a problem sitting, just some minor aches and pinches. Not enough to even warrant pain medication (I took it the first day just because I was worried about the first BM, but that came out smooth).

I took my cell phone into the bathroom with me incase I had to dial 911 during my first BM after surgery, that's how insane I was after reading all the horror stories. But it was the most pain-free BM I have had in over a year.

2 weeks after surgery I am still leaking some light brownish mucus or puss. I see the CRS tomorrow and hopefully he says it's normal discharge. No more blood or any of that thin brownish fluid that lightly stains a large portion of the gauze.

When I told the CRS about my after surgery worries, he kind of scoffed at it, as if it was nothing. At the time I didn't like that, but now I see why I did it- because the worries were just that. The actual outcome was pretty damn good.

Being that we are a support forum, naturally it is mostly those who are experiencing pain, discomfort, discharge, blood - or simply anxiety - etc., who come here. That is what we are here for. And most who have had the surgery are off here after a month. So, I think we are doing what we set out to do, offer advice and support.

Savaici wrote:Being that we are a support forum, naturally it is mostly those who are experiencing pain, discomfort, discharge, blood - or simply anxiety - etc., who come here. That is what we are here for. And most who have had the surgery are off here after a month. So, I think we are doing what we set out to do, offer advice and support.

It's like any forum. If you go to a car forum all you see are complaints and problems with the car. That's because all the millions of people who don't have issues with the car don't come on the forums.

That fact just needs to be realized. While I know it to be true, I fell into the trap myself.

Well perhaps I got a little too excited too early. My fistulotomy wound has completely healed, but there is a pretty good amount of aching pain coming from the area. Not sure why, it's been lasting for about 4 days now, it's worse when I have a bowel movement. Externally everything looks great, there isn't even a scar anymore and this was a pretty deep wound. I am worried it is recurring, but- 1.) I don't have Crohn's disease or any other IBD nor do I smoke, 2.) There is no pus, discharge or blood coming from my butt at all and there is no hole or bulge on the skin anywhere, 3.) There is no abscess and there is no fever...there is merely just pain. I wonder if this is the new skin being stretched when I BM? Or did the fistulotomy inadvertently cause a fissure? Or bad hemorrhoids? I'm visiting my surgeon tomorrow to figure out what the hell is going on. He has pretty poor bedside manners but I have confidence that he will know. I would assume a recurrent fistula would involve discharge and an abscess...or at the very least discharge or blood from my rectum. Everything LOOKS normal, it just hurts.

Cporosus1 wrote:I would assume a recurrent fistula would involve discharge and an abscess...or at the very least discharge or blood from my rectum. Everything LOOKS normal, it just hurts.

Before my surgery, my fistula hurt the worst when there was no discharge. It wasn't too bad when the discharge was coming out, but when it closed up and the puss built up, that's when the pain got bad. Some people have had L&D (Lance and Discharge) to ease the pain.

I think it is very possible that the new skin/scar tissue is painful and may be for quite a while after appearing to be healed. I am going though a similar thing myself right now, although am still healing. Even though it is physically looking better it is hurting more.

I hope your appointment gives you some good information. Let us know how it goes.

Surgeon says there is no fistula recurrence nor any sign of infection. It is 99% healed but a tiny raw bit of skin remains. He reckons that is what is causing the pain, although I think the scar tissue could be as well. I'm perfectly happy so long as I don't need another fistulotomy :)

A success story for fistula (and AF) which is quite a good one. This is the link: my-surgery-diary-lis-fistula-repair-t5158.html#p75825

Have been looking around to see what I can find so that we could possibly put them in a sub-forum for Fistula success and diaries. Being mostly an AF group, there are obviously not as many posts, but we are happy to help where we can with positive stories.