Superficial anal fistula? What? How? Treatment? | Dr. Chung answers YOUR questions! 

Thank you!

Hi , how can i contact you 🥺 I've got questions

😮

How can I contact you. Have some questions. Dr follastad is my doctor as well. I have fistula , is considered to have surgery. Thanks!

@@paulalee9884 I put my email address couple of times for some reason it don’t show.

@@manongsfoodreview5141 did have simple or complex fistula. How long was the recovery. Any tips to share? Thx!

How painful was the recovery? I’ve just recently been diagnosed with an anal fistula, however I’m still waiting to see my GI to find out how bad it might be because I have active Crohn’s disease but only really having issues in my rectum right now. Less than two weeks ago I started to get this agonizing pain in my rectum which I thought was due to my thrombosed haemorrhoids but because I’ve had those before I knew there was something else wrong. In less than 7 days it got so bad that I couldn’t get out of bed, couldn’t walk, sit down, go to the washroom or even sleep without agonizing pain which is why I eventually ended up in the ER. That is where they discovered a perianal abscess near my rectum in a CT and decided to drain it right there and than and OH MY GOD, I have never felt so my h pain in my entire life and I’ve had Crohn’s for over 15 years, also severe complications with my spine! However, this was by far the worst pain I have ever experienced which makes me think something went wrong when they cut into my abscess. To be honest, I just had a full colposcope and endoscopy a few months ago and didn’t detect a fistula whatsoever, so unless these things can form quickly I think the ER doctor in fact cut too deep and did this to me! So angry! Anyhow, now I have an open wound that won’t stop oozing puss (it also tested positive for e.coli infection) for 6 days now and going to the washroom is torture. So now I’m looking at my options to try to heal this or have it repaired but have heard so many say that things like fistula and hemmorroid repairs can be so bloody painful. I was just coming out a 6 month flare and finally starting to feel good when this happened, so while I can handle an extreme amount of pain I feel like I’m on the verge of giving up because this pain is just so unbearable. So I’m just wondering what the recovery for something like this would feel like. I’m also a natural health advocate and for the longest time was dealing with all my health issues naturally with some great success so this all comes as a shock to me and to think it all started due to an extreme amount of stress O endured a few years ago after both my father and mother-in-law were killed by the medical establishment during CV. So on top of everything else, I also have white coat Syndrom and don’t trust many medical professionals anymore especially after watching how they handled the last 4 years.

Not sure yet. More long term data needed.

How are you now? Does it hurt? Dressing/packing wound etc?

@@metaphorsk I'm now 4 months post-op. Overall, I'm doing well. Don't really have any pain, and if I do, it's mostly mental. I didn't have to do any dressing/packing or anything like that after surgery. Brief timetable of everything: Sept 21 - Fistulotomy Next 7-10 days, low fiber, low residue, largely liquid diet, and about 3 sitz baths per day. Took about 36-48 hours post surgery for first BM. Not pleasant, but not as bad as I feared. After about 3 weeks, the daily blood and pus drainage had subsided about 95%. Oct 18 - Four week follow-up with surgeon. He said to count on another 4-8 weeks healing time. The wound was still open, still slightly swollen, still draining slightly. Mid November - Around the 8 week mark post surgery, I thought I was out of woods, as my butt sweat post workouts had a normal pattern for the first time. Then the morning after Thanksgiving, after not wearing pad or anything overnight, had significant drainage overnight, but not blood, pus, or feces. Liquid. Either water, sweat, or clear mucus. Dec 12 - Twelve week follow-up, I expressed concern about my drainage/leakage overnight. CRS declared me fully healed and said I had a sweaty butt. The drainage I am/was experiencing overnight is not that of normal butt sweat, though. Fortunately, I was able to find some forums on Reddit and Quora, and people who dealt with the drainage for up to 9 ,months to a year post surgery. I will say, 2 of the past 3 days, I've had less drainage. I am documenting any overnight drainage with pictures of my underwear, and was told by PCP about a week after CRS 12 week follow-up, that if I was still dealing with that at the 6 month mark to either call CRS and demand to be seen, or call PCP for referral to different CRS. Unfortunately, it's just a long process and you have to be patient. My diet is about 95% back to where it was pre-surgery. I still try to be careful and not overindulge, or eat anything too greasy or spicy. I'm really hoping the trend I've noticed over past few days continues, and if it does, maybe I'll be out of the woods by this time next month. I'd be happy with that.

Great question! It has been added to the list.

@@yourfriendlyproctologist doc what do you called if you have two fistula on both side of my butt

Best of luck!

Hi there. Was wondering if you could give an update on your post op experience? It would be greatly appreciated.

Any update on ur recovery?

@@gigia3401 I had mine yesterday. Keep the stool soft postop would be my #1 advice. Eating lots of papaya, both green & ripe along with miralax, metamucil & 3 dulcalax stool softner. Stay away from laxatives though. The pain is less than Sphincterectomy. But still in pain. But again I m only on my 2nd day.

@@limgm.2551 hey how you doing now? and how was the pain after BM. Is the pain bearable

You don’t feel anything now from 2 years after the surgery

How are you now? Fully recovered?

So how it's going now?

@@TechyAviral I had the OP and it was laid open. It was quite painful but not as much as others have said. I felt ok after 2 weeks and went a 2 hour walk and bleed out so having to take it easy. other than that, it seem to be healing quite well and the usual pain and irritation I have had from it is not there anymore - fingers crossed 🤞🏼

​@@captainvuk1 I hope u do fine is your fistula was deep close the the anal

@@captainvuk1 update?

@@davidc2837 it feels like it’s gone back to when i first started to feel it. there is not that much pain if any at all - then I feel a niggle. So it’s still there but no where near the pain and discomfort as before. It’s More just an awareness of it now.I have an appointment with the surgeon coming up so I will let you know more then. I would be happy if it stayed this way. Fingers crossed:)

How are you now?

In Germany, they used general anesthesia for my surgery. It was not just a fistulotomy, they cut out the fissure that caused the fistula. First week was a little painfull, but really managable. First poop was scary. I had to use the shower head to clean the wound 4-5 times a day (and after every poop) for 4-5 minutes. Than put a dressing with ointment on the wound. After about 3 weeks, the cleanings can be done less often, about 3 times a day. It's healed more or less so you can do everything like easy sports after 4-6 weeks, and the wound is completely healed after about 3 month. But it was a resection of a fissure, as I said. The Dr. said, there are more chances it heals completely if they remove the cause.

18 years ?

im going on 1 year. same as you describe.

I have mine for 24yrs seen Dr yesterday

I have had for 1 week and it hurts

How does anal fistula looks like? Can we see it from outside?

I don't believe there is a benefit. But there's no problem with adding in the salt if you like it!

These are all good questions. It seems to me you need to continue the discussion with your surgeon. You may also consider a video consultation with me as well. Wish you the best.

Hi @professionalviewer5672 how are you now?

It varies. It's why I see my patients 2-3 times a week after this surgery.

My surgeon said it should b mostly healed by 2-3 weeks. 2 months sounds awfully long. Change your colorectal surgeon & see possibly two additional different surgeons to cross check what they suggest. Good luck!

Mine does the same thing. Most of the time I don't even know it is there.

LOLOL!!! Holy moly that was so funny.

Your story is a bit more complicated since you had several procedures for your fissures. I would need more information to give a helpful response. Check the description box for video consult details if you are interested. I wish you the best.

What type of procedures did you have!! LIS is typically the gold standard for fissure & once should be enough or at most twice. 5th sounds awfully too many procedures.

Hard for me to say without more detail. Look in the description box if you are interested in a video consultation.

thank you for explaining about fistula

@@jwilde2769 how you doing now

How is his wound now? Was anything done to treat his would?

Mri, endo anal scan, MR fistulogram

Hey, how you doing now? All ok? And how were the first bowel movements. Pain bearable?

I hope u doing well ... how is going

@@ameernasri9761 I am good

​@@Bikgyadid you have MRI to know it was superficial? Did you have fistulectomy or fistolotomy?

@@Bikgya How was your recovery from surgery, and total time?

Update?

You surely know now how long it took, but for others: I think, the pain level is different for everyone and every surgery is different. And it depends on your job. If it's a job that can be done from home lying in bed with your laptop, you can start sooner. If it's a job where you are physically active, it takes longer to be able to work the whole day.

Hello, several months later "I'm doing incredible!" The surgery was very successful and the recovery wasn't without some challenges! However, I did quite a few follow-up visits to my Doctor. I did experience so interesting things, which I found out was "normal" to the healing process. because I DID NOT want anything to grow back and the least little itch, slight pain or slight blood I made an appoint to be reexamined lol! So Far SO GOOD weeeeeesh! @@amritnalam9994

Great Point! So Grateful to be on the other side of this situation! Never that something so "small" can shift your life! "I cld write a book"!@@lenakohl2339

I hope philippines do have

Sorry, I'm not exactly understanding your question.

I believe he's talking about LIFT, Litigation of the Intersphincteric Tract.

Did she consultant doctor and took antibiotics. Sorry for your loss. Sad

It's possible. I recommend seeing a specialist near you for a proper diagnosis.

How are you doing now ? I might have same issue

@@sanpat2220 I still have it, it comes for a few days and goes for a few days.

@@zosefsotheoherrero171 how you doing now

Both ends

usually 4-6 weeks. depends on what was done in surgery.

Is there a complete cure? Cause doctor told me there’s 50/50 chance that I’m healing and recover 100% from it

You will need to speak with your surgeon about your surgery. Wish you the best.

How are you doing now??

@@sanpat2220 almost done, it Indeed regenerated, it's been a slow recovery but with no pain

@@AdlvRegnum hey how you doing now? and how was the pain level during BM

any update will?

@@davidc2837 I’m actually glad you asked. I have a new one that showed its head but the first surgery wound has healed some. Definitely feels like melted flesh 😂

@@Scyffe how long were you symptomatic before getting the surgery? edit* I'm sorry to hear that too :( i hope you recover.

Aapke kya tha bhai ?

How are you now?

I was prescirbed pain killers and made sure to keep the stool soft. The first time was scary and took some time, but after a couple of days it was better than the discomfort I had before surgery.

Symptoms?

@@559talk9 mostly recurring abscesses showing up every 1-2 weeks near my inner thighs, groin, an anus area. Tend to resolve on their own but mostly been using warm wet compresses to draw out the inflammation .. they usually vary in size and form generally in the same locations over and over again. I can tell when I’m getting one bc the area becomes slightly painful, a small bump appears and is painful to the touch also usually red.

@@graphicsguy2023 thank you. Do you have discharge? It’s pretty crazy but I have no pain or issues with bell movement I just notice after I pass stool a few hours later it’s damp on that area and kinda brownish discharge appears. No pain or blood. Not sure what it is

Can you see a fistula from outside? How does it look like?

@@kinnubuttardhillon7899 my doctor told me by insert his finger in anal, and verified that I have superficial anal fistula. I didn't see any from out side??

Thanks for your story. In general, your story does not sound like a typical recovery. Definitely see your surgeon for an examination.

Hi Dr Chung thanks for the reply,I will do that,could I ask you how long is it supposed to take on average to heal something like this,is it weeks or months for it to be fully healed. The reason I haven't gone for an examination is the car trip to get to the hospital is around 50 minutes each way and I have been worried sitting on a car seat for so long will do the wound damage aswell being painful.

I had my perennial abscess removed left & right & top bums since early August 2021. Like a horse shoe shape. Now I find out I have anal fistula from the previous surgery. It's a long journey... still on road of recovery.

@@kass4065 how are you doing now ?

@@garryw1974 so have you healed?