Fistulas are abnormal connections between two or more organs or even vessels. Fistulas occur to those organs and vessels that are otherwise not supposed to be connected. These can occur in many body organs such as anus, urinary tract, vagina, intestines, skin or even the aortas. However, the most common one is the anal fistula.
When infections occur in the fatty layers of the anal muscle or tissue, anal fistulas develop. Many a times, these fistulas increase in size and forge an outlet. It extends to the area between the urinary opening and anus, known as perineum. As the infections also spread to these fistulas, they become extremely painful. In such a case, the fistula surgery is the only way out. It helps in the draining the secretions and over time, the fistulas start to close and heal.
About the Fistula Surgery
The surgeon will remove the fistula or close its opening through the fistula surgery, also known as Fistulotomy. Here, it must be mentioned that if you are thinking of going for a fistula surgery, it is always advised that you do it as early as possible. The more you are late, the more complications will arise, as the fistulas always have a tendency of increasing in size, making it more difficult to treat.
The doctor will make an incision in the fistula and disconnect the connected organs or tissues. Usually, it is a small procedure that can be done at the doctor’s office and it is also an outpatient procedure that usually doesn’t require any hospital admission. However, in case you have an elaborate fistula, you might have to be admitted to the hospital and go for a general anaesthesia during the surgery.
What to Expect After a Fistula Surgery?
Usually, you can expect to leave the doctor’s premises on the very same day of the surgery. The doctor will ask you to stay in rest for about 24 hours or at least for the remainder of the day. For the fistula to be completely healed, it takes quite some time – about a few weeks or months as well. However, within a week or two, you would be able to return to work. The things that you can expect from the surgery as well as post that is:
Dressing on the Wound:
Usually, there is a dressing on the wound after the surgery. The doctor will ask you to give it a light pull, in order to remove the dressing the next day. This may result in some bleeding, but there is nothing to be worried about. However, if the bleeding is alarming, you may contact the doctor.
Digitating the Wound:
The doctor will also ask you to ‘digitate’ the wound in which you will have to run your finger through the wound in order to prevent the top layer of the wound from healing too fast. This will prevent the fistula from recurring.
Mucus Secretion from the Seton Stitch:
In order to prevent the sphincter muscles from being damaged, a set on thread is inserted right through the fistula and a knot is tied outside, so that the infection is healed and drained. However, this seton also causes some mucus leakage that may be itchy and make the area sore and wet. Hence, you might have to take bath more frequently or wear a pad in your underwear, to prevent the wetness.
Bleeding and Pain During Bowel Movement:
One of the biggest questions that come to the minds of patients with an anal fistula surgery is whether bowel movement will be painful or not. To be true, you must be prepared to encounter some pain and bleeding along with your bowel movement. This will persist for about a week or two. However, if you include enough fibre and fluid into your diet, it would be less painful and more comfortable for you.
Sometimes, doctors recommend you to take laxatives and stool softeners for a more comfortable bowel experience. Often, sitting in warm water after bowel movement provides comfort and relief to the patient. If you are taking bath, pat the anus area dry. You can use a baby wipe to clean the anal area to get rid of the pus, blood and mucus that might be coming out of the region post-surgery.
To deal with the pain, the doctor will give you some painkillers or medicines. As soon as your medicinal cycle ends, you should know that you are likely to slowly start your usual daily routine.
Taking Care of Yourself Post Fistula Surgery
Now that you have known what to expect after a fistula surgery or Fistulotomy, you need to know how to take care of yourself.
Activities to be Engaged in after Fistula Surgery:
Like any other surgery, in case of fistula surgery as well, you need to take proper rest as well as engage in some kind of activity every day, so that you heal faster, without exhausting yourself.
- Take rest when you feel tired.
- Walk every day. Increase your walking range every day. This will improve the blood flow and reduce the chances of constipation as well as pneumonia.
- Start driving after you have completed your painkiller course. This will ensure that you can sit comfortably for long, switch your legs between pedals.
These small activities prove to be very useful in faster recovery.
Diet After Fistula Surgery:
As already mentioned, include more fibrous and liquid foods into your diet to keep the bowel movement smoother. Have low fat and broiled and boiled food as much as possible to avoid constipation.
Medicines After Fistula Surgery:
One thing that your doctor will tell you is to refrain from taking some medicines like blood thinners etc. for a few days after the surgery. Ask your doctor for the right time to resume taking the medicines.
Sometimes, people take the over the counter pain medicines like ibuprofen. However, taking narcotic medicines is absolutely prohibited. You must see the doctor regularly to make sure that healing is proper. About 92% to 97% of all anal fistula surgeries have a high long term success rate. Hence, if you have a fistula problem in your anal region, getting a fistulotomy as early as possible is a good idea.
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