Fistulas are abnormal connections between two hollow organs such as the intestine and bladder or small and large intestines.
They are often caused by a medical condition. Fortunately, there are numerous treatment choices available for fistulas. Here are some things that doctors need to tell patients who suffer from this condition:
1. It’s not Contagious or Infectious
Fistula is an incontinence-causing condition that develops as a result of a damaged or weakened section of the bowel.
This can happen after a particularly bad bout of diverticulitis, or from an unrelated condition.
Treatment for fistula involves surgery to correct the damage and reroute the digestive tract. But what many doctors don’t tell their patients is that fistula is actually not an infection or a contagious disease.
So, if you’re worried about passing it on to someone else, you don’t have to be — though you should still practice good hygiene.
2. There are Two Kinds of Fistulas
There are two kinds of fistulas: Simple fistulas and enterocutaneous fistulas (ECFs). Dismissive doctors might not tell their patients that there are different kinds, but they should.
According to WebMD, simple fistulas do not go all the way through the intestinal wall, whereas ECFs do. Both can potentially be corrected with surgery, but ECFs require more extensive procedures and more frequent follow-ups after treatment.
3. It’s Common
It’s estimated that about 2 million Americans have a fistula — most often as a result of surgeries for Crohn’s disease or ulcerative colitis — and about half of them are able to have it surgically repaired.
4. You’re not Alone
Most fistula patients will feel embarrassed and unable to talk openly about their condition mainly because they feel that they are the only ones.
It helps to let them know that there are other people in the same predicament and that it can be addressed accordingly.
5. Fistulas are Nerve-injury Problems
Even though fistulas are most commonly associated with Crohn’s disease and ulcerative colitis — chronic illnesses that can affect any part of the digestive tract — they’re actually nerve problems.
Nerves don’t always grow back when you have one of these diseases, or when you have surgery on your intestine.
That leaves thousands of people with chronic pain and incontinence that they’ll have to manage for the rest of their lives.
6. You May Need a Colostomy

9 Things Doctors Should let Fistula Patients Know About the Condition – You May Need a Colostomy
Doctors used to consider a colostomy (the procedure of using an opening in the abdomen for waste disposal) as being the last resort for people with complicated cases of Crohn’s disease that couldn’t be treated with surgery or medication.
That’s not true anymore: A growing number of doctors are performing colostomies on patients before they start treatments like chemotherapy because it gives them time to heal before going through more aggressive procedures.
7. It’s Not Just the Crohn’s
Sometimes, doctors will tell their patients with Crohn’s disease that they have a fistula because it’s easier to tell them that than to explain that it might be a complication of the disease.
That can make patients feel as though their symptoms aren’t real and that they aren’t being taken seriously.
It can also send people down a wrong path, as they try to treat what they think is an infection rather than addressing their underlying condition.
8. It’s Not Always Easy to Diagnose
Fistulas can be hard to detect, sometimes even for trained doctors who see lots of patients with Crohn’s every day. Plus, it may take time for symptoms to develop once the fistula forms.
If your doctor doesn’t seem particularly knowledgeable about Crohn’s or isn’t paying much attention to your symptoms, consider going to someone else for a second opinion or even getting a third opinion if the fistula is still not diagnosed after several visits with different specialists.
9. Fistulas Have no Cure
The condition is not curable but treatment is available. This is perhaps the most important thing to understand about fistulas, especially if you’re dealing with an internal one.
While some internal fistula cases can be resolved with surgery, others may require additional procedures in order to fully repair them.
Attempting multiple surgeries on the same fistula has no benefit over attempting a single surgery, so you want to make sure you speak with your doctor about your options before proceeding with additional treatments.
Final Thoughts
Fistulas are a type of urinary incontinence that can affect people who have undergone pelvic surgery.
Since the symptoms often mimic those of other disorders, it’s important for patients to have a clear understanding of the condition and its treatment and it is your job as a health practitioner to do that.
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