“I was recently told I have two GI Fistula’s?”
I have a history that includes a 15lb tumor that was surgically removed from my uterus, at the same time my surgeons had to do a complete hysterectomy. (I do have one ovary) About 15 years later I’ve had two bowel obstructions that had to be surgically repaired, my appendix and gallbladder removed (the surgeon knew I had a hostile abdomen due to severe adhesions but accidentally nicked my bowel), I ended up getting abscesses and had to have two more surgeries that month. I ended up with a wound vac for four months. I then had a partial bowel obstruction, my doctor did not have to do surgery this time. Before I was released we discovered two fistulas, one on each side going from my large bowel to small bowel. Since I’ve been home I’ve been struggling with belly pain, nausea, vomiting, diarrhea, a low grade fever and feeling completely exhausted. What are the long term effects of having these fistulas? Will the pain and nausea get better? What can I do to help them get better? What can a doctor do to help?
Female | 50 years old
Complaint duration: 30/09/2021
Medications: Bydurion, metformin, trazedone, latuda, lithium, clonidine, clonazepam
Conditions: Diabetes, hypertension
6 Answers
This is serious stuff. Go see a Gi specialist at a university hospital.
You may have a condition called blind loop syndrome and SIBO related to the fistulae and only the specialists who are treating you and have access to all your test results can give you the details.
A very difficult problem that this patient presents. In general, fístulas can close if there are the following conditions:
1. No distal obstruction to the fistula
2. Bowel is put to rest. Need parenteral nutrition
3. No active infection
4. No foreign body
5. No chronic disease or cancer
In the case presented, I am not sure that 1 is not present and certainly 2 is not done. To answer patient questions, I need to know more about the timing of the discovering the fistula and what diet the patient is getting. My guess is that modification of diet could help the symptoms, but eventually surgery is the most effective manner to control and fix problems. However, with the history presented there is a great chance of complications due to previous surgeries and it could make things worse. I will advise it only if the patient is unable to sustain symptoms.
Carlos Barba, MD
1. No distal obstruction to the fistula
2. Bowel is put to rest. Need parenteral nutrition
3. No active infection
4. No foreign body
5. No chronic disease or cancer
In the case presented, I am not sure that 1 is not present and certainly 2 is not done. To answer patient questions, I need to know more about the timing of the discovering the fistula and what diet the patient is getting. My guess is that modification of diet could help the symptoms, but eventually surgery is the most effective manner to control and fix problems. However, with the history presented there is a great chance of complications due to previous surgeries and it could make things worse. I will advise it only if the patient is unable to sustain symptoms.
Carlos Barba, MD
You have a tough case with post-surgical complications. The fistulas are related to that, and not to a separate inflammatory condition like Crohns disease. sometimes, people with your history are suspected to have Crohns, but in reality it is all related to post-op complications. The fistulas will tend to stay open and may cause diarrhea but I would not expect them to cause all of the other symptoms you are describing. One possibility to fix them is to find the opening in the colon and try to close it using metal clips during a colonoscopy. A GI doctor may be able to localize the opening and attempt closure endoscopically.
Consult Functional Medicine. Change to an organic/non-GMO/low gluten diet. Juicing: organic carrot/beet/ ginger 1 glass daily. Your thyroid, Vitamin B12 and Vitamin D have to be above 75 percentile.
Hello,
I am sorry that you find yourself in this situation. My experience with these cases is that you have to get this fixed, as in get the fistulas treated or you will have recurrent abscesses and bowel obstructions and maybe septic from this. Your best course of action is to go to a major teaching hospital or referral center, (tertiary care center) there are many across the country. You should start at a University hospital or at a Place like Mayo Clinic or Cleveland Clinic, Do not let this simmer and get worse, you should seek expert care.
I am sorry that you find yourself in this situation. My experience with these cases is that you have to get this fixed, as in get the fistulas treated or you will have recurrent abscesses and bowel obstructions and maybe septic from this. Your best course of action is to go to a major teaching hospital or referral center, (tertiary care center) there are many across the country. You should start at a University hospital or at a Place like Mayo Clinic or Cleveland Clinic, Do not let this simmer and get worse, you should seek expert care.
