Crohn’s Disease Fistula – How Can They Effect You And What Are They?

If you have had Crohn’s Disease for awhile you may already know what a fistula is or how it can affect you, or if you were like me I didn’t know what a fistula really was till years after I was diagnosed. I have been lucky and have never been affected by a fistula all the years that I have had Crohn’s Disease. 

A Crohn's Disease fistula is an abnormal tunnel connecting two body cavities that are not usually connected, such as the rectum and the vagina. A fistula can also be a body cavity to the skin such as the rectum to the outside of the body. 

One way that a fistula can develop is through an abscess. It can be common to have a fistula if you have Crohn’s disease, around 25 percent of people get them.  

Severe diarrhoea or constipation can result in a tear, or fissure, in the lining of the rectum. Most people have had a tear or fissure on the corner of their mouth, which can occur in winter/cold weather and also if you yawn.  

Much the same way an anal fissure is a small tear of the lining of the anus, caused by diarrhoea or constipation. Fistulas can also form from sores and ulcers caused by inflammation. If an ulcer goes deeper and penetrates through the intestinal wall, this is another way that a Crohn's Disease fistula can form. 

These anal fissures can cause intense pain when you have a bowel movement (before and after) which will stretch the fissure. The majority of fissures will heal on their own some require surgical repair. Fistulas can be a common cause of sepsis in Crohn's disease. In some cases, sepsis can be life threatening. 

Some symptoms of fistulas that are between sections of intestine are - increased diarrhoea, malabsorption of nutrients and dehydration. A vaginal fistula causes intestinal waste to leak into the vagina.  

Faecal contamination of the bladder, in a bladder/vaginal fistula can cause urinary tract infections. The most common fistula in Crohn's Disease is the anal fistula — this connects between the rectum and skin around the anus. Anal fistulas can be, but are not always associated with an abscess. 

Over half of the people with fistulas, no real treatment will be required as the body will heal it or non surgical methods can be used. Stool softeners maybe used to help reduce the pain during a bowel movement. You may be put on antibiotics for a short period of time as well.  

If that is the case make sure that you are taking some kind of probiotic so that your bowel flora stays healthy. Antibiotics kill the good bacteria in your system as well as the bad ones. 

If a fistula will not respond to treatment, your doctor will have another look at you. Such things as muscle scarring and spasms can affect the healing process in a negative way.  

When a Crohn's Disease fistula doesn’t heal then it may need to be corrected with surgery. If this is the case there is no need to worry as this is a minor operation and is usually done on an outpatient basis.  

The surgeon will remove the any underlying scar tissue and the fistula, by cutting away a small amount of the anal muscle it will stop spasms.  

This helps the area to heal and it is rare for it to interfere with the control of your bowel movements. The pain often goes in a few days, but it will take a couple of weeks for complete healing.