Fistula surgery recovery: Tips and what to expect (2022)

Fistula surgery recovery takes time. After this type of outpatient surgery, a person will need rest before they can return to their usual activities.

While a fistula can happen anywhere in the body, most fistula surgeries remove fistulas in the anus and rectum.

Fistula surgery removes an abnormal tissue connection and sometimes the area surrounding it. The most common types of fistula surgery are fistulotomy, which is an outpatient procedure to remove only the fistula, and fistulectomy, which is a more complex surgery that removes the entire area the fistula affects.

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A fistula is a tunnel or clump of tissue that affects two structures in the body. It can affect most areas of the body, but one of the most common locations is the anus. This can affect function, cause pain and constipation, or lead to infections. If the outer hole of the fistula closes, it may create a swollen, pus-filled, painful abscess.

Fistulas often happen following surgery on the anus or rectum. An infection that forms an abscess may also lead to a fistula, especially after surgery. Cancer, foreign bodies in the rectum, radiation therapy, and inflammatory bowel disease may also increase the risk.

No medication or lifestyle changes can cure a fistula. Surgery is usually necessary.

(Video) Anal Fistula Recovery Time | Dr. Kiran Shah by Apollo Spectra Hospitals

Surgical treatment is highly effective at managing fistulas. The right surgery depends on the type of fistula a person has.

The most common type of fistula is an intersphincteric fistula. This is a fistula that begins between the internal and external anal sphincters and opens outside of the anus or close to the outside of the anus. A person may see or feel this type of fistula. The types of fistula surgery include:

  • Seton drain placement: A seton drain can help drain an infection. This may reduce the risk of developing a fistula or, if someone already has a fistula, delay the need for more invasive surgery.
  • Fistulotomy: A fistulotomy is a procedure that cuts the connected tissue that forms the fistula. A doctor can often do it on an outpatient basis, and a person does not need to stay in the hospital.
  • Fistulectomy: Fistulectomy removes the tract of tissue that contains the fistula, as well as the fistula itself, rather than just cutting the connection between the two tracts. It poses a higher risk of complications because a doctor has to cut into the affected organs — usually the anus — not just the band of tissue connecting the organs.

The recovery time for fistula surgery depends on the type of surgery a person has, their overall health, whether they have an infection, and the skill of the surgeon. Success rates also vary and can affect how soon a person feels better.

For example, an older 2013 study of people who had a fistulotomy found an overall success rate of 93% 11 months after surgery. In the same study, 20% experienced declines in their continence after surgery. Delayed referral for surgery increased the risk of incontinence, while secondary growths on the fistula increased the risk of surgery failure.

(Video) What is the recovery time after a Fistula surgery

With a fistulotomy, a person will usually go home the same day. They may have some pain and drainage from the wound but should be able to return to work within a day or two. A doctor will usually recommend against heavy lifting and sexual activity for a few weeks.

A fistulectomy has a longer recovery time because a person needs general anesthesia. This means they will need to have the procedure in the hospital and may need to stay overnight for monitoring. There is a higher risk of infection and incontinence with this type of surgery. A person may need several weeks to feel better and may need to stay home from work for a few days.

After a person fully recovers, in most cases, the fistula heals, and a person will not have lingering issues such as incontinence. But if there are surgical complications, a person may need additional treatment or more surgery.

Some strategies to reduce the risk of pain, infection, and other issues include the following:

  • Talk with the surgeon about recovery time and other precautions.
  • Rest after the procedure, especially if it involved anesthesia.
  • Ask a doctor if a less-invasive procedure, such as a fistulotomy, may be an alternative to a fistulectomy.
  • Ask a doctor about their experience performing fistula surgeries and the rate of complications.

Living with a seton drain

(Video) What happens if I don't have fistula surgery now?

A seton drain is a drain that can help heal anal fistulas. Some fistula surgeries involve placing such a drain to help remove pus and other fluids from infection and heal the fistula.

A person may have spotting or bleeding for 1–2 days after the procedure, and pain for 1–2 weeks. In most cases, a person can return to work the day following the procedure if they feel well.

There is a small risk of incontinence, infection, and other complications. People who notice pain, bleeding, or a bad smell should see a doctor right away. Because constipation increases the risk of complications, it is important to eat plenty of fiber and remain hydrated.

An older 2012 study of 53 seton drain recipients found a 3.8% incontinence rate and a fistula recurrence rate of 6.5%. Horseshoe-type fistulas had a much higher rate of recurrence, at 57.1%. This study involved a seton drain that drained the fistula in stages over time.

A seton drain may be permanent or temporary.

If a person gets a seton as part of a fistulotomy or as a standalone surgery, scar tissue may form around the seton. A surgeon may need to trim down this scar tissue or perform a second procedure.

Fistulectomy and fistulotomy may also cause scarring. In most cases, the scars are not a problem, but some people notice pain or tenderness at the site of a scar. A person should talk with a doctor if the scar tissue is uncomfortable or if they notice a large mass at the surgical site.

(Video) What is the duration of recovery post Anal Fistula Operation?-Dr. Prakash Mahadevappa

The wound from fistula surgery will continue to drain after surgery, especially if a person has a seton drain. This drainage is important and helps remove the infection from the body.

Ask a doctor about proper wound care. They may recommend applying sterile dressings, rinsing the wound, or applying cream to the wound. Do not pick at the wound or put anything on it without first talking with a doctor.

Here are a few tips to help with recovery from fistula surgery:

  • Avoid sexual intercourse, or inserting anything into the rectum or vagina, until a doctor says it is safe.
  • Follow up with a doctor after the procedure. Most providers schedule a visit a few weeks after surgery to ensure healing is going well.
  • Drink plenty of water to reduce the risk of constipation and keep stools soft.
  • Ask a doctor when to go to the hospital or follow up. In most cases, a fever, increased bleeding, increased pain, or pus from the wound may warn of an infection.
  • Avoid constipation by eating high-fiber foods or taking a stool softener.

A fistula can be painful and scary and may affect daily life, especially if a person has difficulty using the bathroom. It is important to work with a surgeon who has significant experience treating fistulas and to ask questions about the best surgical treatment options for a person’s health goals.

(Video) IBD Surgery: Perianal abscess and fistula

FAQs

How do you poop after fistula surgery? ›

You can make your bowel movements less painful by getting enough fibre and fluids, and using stool softeners or laxatives. Sitting in warm water (sitz bath) after bowel movements will also help. You may notice a small amount of pus or blood draining from the opening of your fistula.

What is the fastest way to heal a fistula wound? ›

Other instructions
  1. Place a maxi pad or gauze in your underwear to absorb drainage from your fistula while it heals.
  2. Sit in a few inches of warm water (sitz bath) for 15 to 20 minutes. ...
  3. Apply ice several times a day for 10 to 20 minutes at a time. ...
  4. Support your feet with a small step stool when you sit on the toilet.

How long will it take me to recover from fistula removal surgery? ›

Around 25 percent of fistulae will heal within 30–40 days with correct nutrition and some medical management. However, the mortality rate for all gastrointestinal fistulae can be as high as 40 percent. As such, it is important for people to seek immediate treatment for this condition.

Can you sit after fistula surgery? ›

You may need rest for a few days after your operation, but you should avoid sitting still for a long time. Also avoid doing too much walking.

Is walking good for fistula? ›

It is important that patients are able to rest for several days following the surgical procedure. During this time, they should allow their bodies to recover, and avoid sitting or walking for too long.

Can poop come out of fistula? ›

Bowel contents can leak through the fistula, allowing gas or stool to pass through your vagina.

Can I eat eggs after fistula surgery? ›

Fruits: Custard Apple, Pears, Grape and Watermelon, Oranges, Papaya, Banana, and Apple. Milk and Milk products: Skim milk, Paneer, Cottage Cheese, Yoghurt. Meat, Fish, and Egg: Tuna, Salmon, Herring, Mackerel, Omega3 fatty fish. Oil: 5 Tablespoon/ day (Olive oil, Mustard Oil, Rice Bran Oil, Canola oil.

What should be avoided in fistula? ›

It is recommended to avoid refined food and also fatty and fried food when suffering from fistula; and include more of fresh fruits and vegetables in the diet. Avoid soft drinks and food products comprising of white flour.

How serious is a fistula operation? ›

Like any type of treatment, treatment for anal fistulas carries a number of risks. The main risks are: infection – this may require a course of antibiotics; severe cases may need to be treated in hospital. recurrence of the fistula – the fistula can sometimes recur despite surgery.

How soon after fistulotomy Can I exercise? ›

You should avoid strenuous activities, including exercise and heavy lifting, for at least five to seven days. Your doctor may recommend waiting longer to resume all of your normal activities. Always follow your doctor's recommendations. You may have some cramping and nausea immediately following the procedure.

What is the fastest way to heal after fissure surgery? ›

  1. Avoid strenuous activity for 1 week after your procedure.
  2. Take sitz baths (sit for 15-20 minutes in warm water) three times a day and after each bowel movement for the first few days.
  3. Don't worry if you have some bleeding, discharge, or itching during your recovery. ...
  4. Avoid constipation.

How painful is fistula surgery? ›

Following your fistulotomy, you may experience some mild to moderate pain or discomfort in your rectal area. You may also experience constipation, difficulty urinating, and possibly some rectal bleeding. The following are some general guidelines for proper care after your procedure.

How long is fistula surgery? ›

How is the AV fistula procedure performed? A surgeon usually performs the procedure in the operating room. You receive a local anesthetic (numbing medicine) at the proposed site along with IV sedation to relax you. Discomfort is minimal and you may even fall asleep during the 1 to 2 hour-long procedure.

Can I go gym after fistula surgery? ›

Activity After Hemodialysis Fistula or Graft Access Surgery

Please avoid heavy physical exercise or exertion for two weeks.

Can I drink alcohol after fistula surgery? ›

You can safely drink alcohol again 2 days after finishing your course of metronidazole.

Can a fistula reopen? ›

Unfortunately, despite proper treatment and complete healing, an abscess or a fistula can come back. If an abscess comes back, it suggests that perhaps there is a fistula that needs to be treated. If a fistula comes back, additional surgery will likely be required to treat the problem.

What is the success rate of fistula surgery? ›

Fistulotomy remains one of the most commonly performed operations for anal fistula with a reported success rate ranging from 87% to 94%.

Can fistula cause weight loss? ›

In addition, when the body is fighting infection it needs more nutrition than normal. Therefore, with less absorption and higher nutritional requirements, patients with fistulae can quickly become malnourished and lose weight.

How can I reduce fistula pain? ›

Sitz bath - one of the best ways to aid symptoms of anal fistula that include irritation, swelling, pain and inflammation is a sitz bath, which is a process of soaking the anal area in plain warm water. A sitz path taken at least 3-4 times every day can be soothing and relieving.

How much weight can I lift with my fistula arm? ›

Conclusion: Hemodialysis patients can safely use their fistula arm to lift objects weighing less than 6 lb, which encourages increased motion and helps preserve the functionality of the fistula arm.

Can we eat chicken after fistula surgery? ›

What can I eat after fistula surgery? You can eat your normal diet. If your stomach is upset, try bland food, low-fat foods like plain rice, broiled chicken, toast, and yogurt.

Is banana good for fissures? ›

Banana. Bananas are a good source of fibre, making them suitable for improving constipation. In addition, they prevent the worsening of fissures by softening stools. Bananas also act as food to the good bacteria in the gut.

Does alcohol cause fistula? ›

Pancreaticopleural fistula (PPF) has been recognized as a rare complication of chronic pancreatitis with an estimated incidence of 0.4% [1]. They are most likely associated with alcohol-induced acute or chronic pancreatitis but can also be associated with trauma or iatrogenic injury, among other causes [2].

Is sitz bath good for fistula? ›

Anal fistula treatment

You may want to wear a pad over your anal area until you're healed. Sitz baths can help you feel better. Fill the tub with enough lukewarm water to cover your hips and buttocks. Don't use soap, bubbles, or any other products unless prescribed by your doctor.

Is fistula completely curable? ›

Once you have an anal fistula, antibiotics alone will not cure it. You will need to have surgery to cure the fistula. Surgical treatment options include: Fistulotomy.

Is incontinence normal after fistula surgery? ›

Following fistulectomy procedure, the incontinence can range from 11.5 to 20 % [18]. In our study, overall incontinence rate was 8.1% at 18 month follow up using CCIS. Fistulectomy was associated with an overall incontinence rate of 8.88% (8 out of 90 patients). The severity of incontinence decreased with time.

How often do fistulas come back? ›

A table summarizing the risk of recurrence in anal fistulae with different surgical approaches
ProcedureRate of Recurrence
Cutting seton fistulotomy5% to 29% [44]
Fibrin sealants69% [45]
Anal fistula plugs32% [46]
Flap procedures30% to 60% [47]
2 more rows
7 Mar 2019

What are the restrictions after fistula surgery? ›

Keep your wound covered for seven days. Avoid any heavy lifting/ pressure with your fistula arm for two weeks. Do not keep your fistula arm bent for long periods.

How long does pain last after fistulotomy? ›

After a fistulectomy, you should expect a recovery period at home of about four to six weeks. In some cases, it may take up to nine weeks for the wound to fully heal. You may need pain medication for several days. The treated area may be swollen for a while, and there may be discharge present.

How should I sleep after fissure surgery? ›

Getting restful sleep without triggering hemorrhoid pain

In addition to clean cotton underwear and loose-fitting pajamas, we recommend you sleep on your stomach to reduce anal pain and place a pillow under your hips to prevent yourself from rolling over onto your back.

How long does it take for bowels to return to normal after surgery? ›

Most people with constipation following surgery will experience relief after a few days, especially if they receive treatment quickly. Stool softeners and fiber laxatives tend to act within a few days, while stimulant laxatives and suppositories typically work within 24 hours.

How do you sit with a fissure? ›

Sit in 8 to 10 centimetres (3 to 4 inches) of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases discomfort. Do not put soaps, salts, or shampoos in the water.

What happens when fistula surgery fails? ›

If your access is not working well, it can decrease the amount of fluid and toxin removal your dialysis treatment achieves. This, in turn, can affect your overall health and how you feel. If you suspect there's a problem with your fistula, notify your dialysis care team right away.

Is itching normal after fistula surgery? ›

If an individual felt some irritation a couple of months after the surgery, don't panic. Irritation is completely normal; scar tissue develops from fistula surgery. At times, it feels itchy or somewhat sore.

What is fistula surgery called? ›

For perianal fistulas, a procedure called a “fistulotomy” is the most common surgical treatment.

What are the three types of fistula? ›

The three most common AVFs are the radiocephalic fistula, the brachiocephalic fistula, and the brachial artery–to–transposed basilic vein fistula.

How common are fistulas? ›

How Common Are Fistulas? The World Health Organization (WHO) estimates that there are 50,000-100,000 new cases of fistulas every year.

How can I make my fistula stronger? ›

Fistula exercises
  1. Hold a soft ball or rolled wash cloth in the hand that is the same side as the fistula.
  2. Let your arm hang down beside your body.
  3. Squeeze the ball or wash cloth gently and then relax.
  4. Repeat the squeezing and relaxing for 5 minutes.
  5. Do this exercise 3 to 4 times each day.

Can I have a glass of wine after surgery? ›

We ask you not to have any alcohol after your surgery for the same reason: thin blood may make it difficult for your body to heal, which prolongs the recovery stage. Alcohol disrupts how your body absorbs anesthesia, and as a result, may make some sedatives ineffective.

Can I drink alcohol 2 weeks after surgery? ›

For the best result and smoothest recovery, you should fuel your body with nutrients and foods for a healthy recovery and stay hydrated as much as possible. General guidance is that you should avoid alcohol for at least 2 weeks after your surgery.

Does alcohol slow down healing? ›

ALCOHOL SLOWS HEALING

Excessive alcohol consumption is detrimental to wound healing because it significantly interferes with both the inflammatory phase and proliferation phase of the process. A study found that binge alcohol exposure impaired the production of a protein that recruits macrophages to the wound site.

How painful is fistula surgery? ›

Following your fistulotomy, you may experience some mild to moderate pain or discomfort in your rectal area. You may also experience constipation, difficulty urinating, and possibly some rectal bleeding. The following are some general guidelines for proper care after your procedure.

How serious is a fistula operation? ›

Like any type of treatment, treatment for anal fistulas carries a number of risks. The main risks are: infection – this may require a course of antibiotics; severe cases may need to be treated in hospital. recurrence of the fistula – the fistula can sometimes recur despite surgery.

How long does it take an abdominal fistula to heal? ›

Fistulas from the esophagus and duodenum are expected to heal in two to four weeks. Colonic fistulas may heal in 30 to 40 days. Small bowel fistulas may take at least 40 to 60 days.

How can I prevent my fistula from coming back? ›

If the recurrent anal fistula proved to be a simple intersphincteric fistula, then lay-open of the tract with curettage of its bed is usually sufficient, unless the risk of incontinence was high, then a sphincter-saving procedure such as LIFT should be attempted.

Can I eat eggs after fistula surgery? ›

Fruits: Custard Apple, Pears, Grape and Watermelon, Oranges, Papaya, Banana, and Apple. Milk and Milk products: Skim milk, Paneer, Cottage Cheese, Yoghurt. Meat, Fish, and Egg: Tuna, Salmon, Herring, Mackerel, Omega3 fatty fish. Oil: 5 Tablespoon/ day (Olive oil, Mustard Oil, Rice Bran Oil, Canola oil.

How long is fistula surgery? ›

How is the AV fistula procedure performed? A surgeon usually performs the procedure in the operating room. You receive a local anesthetic (numbing medicine) at the proposed site along with IV sedation to relax you. Discomfort is minimal and you may even fall asleep during the 1 to 2 hour-long procedure.

What is the fastest way to heal after fissure surgery? ›

  1. Avoid strenuous activity for 1 week after your procedure.
  2. Take sitz baths (sit for 15-20 minutes in warm water) three times a day and after each bowel movement for the first few days.
  3. Don't worry if you have some bleeding, discharge, or itching during your recovery. ...
  4. Avoid constipation.

Can a fistula reopen? ›

Unfortunately, despite proper treatment and complete healing, an abscess or a fistula can come back. If an abscess comes back, it suggests that perhaps there is a fistula that needs to be treated. If a fistula comes back, additional surgery will likely be required to treat the problem.

Is fistula completely curable? ›

Once you have an anal fistula, antibiotics alone will not cure it. You will need to have surgery to cure the fistula. Surgical treatment options include: Fistulotomy.

Is incontinence normal after fistula surgery? ›

Following fistulectomy procedure, the incontinence can range from 11.5 to 20 % [18]. In our study, overall incontinence rate was 8.1% at 18 month follow up using CCIS. Fistulectomy was associated with an overall incontinence rate of 8.88% (8 out of 90 patients). The severity of incontinence decreased with time.

Can I drink alcohol after fistula surgery? ›

You can safely drink alcohol again 2 days after finishing your course of metronidazole.

Can a fistula make you feel unwell? ›

Anal fistulas can cause unpleasant symptoms, such as discomfort and skin irritation, and will not usually get better on their own.

Can a fistula cause bowel problems? ›

Depending on where the leak is, these fistulas may cause diarrhea, and poor absorption of nutrients. Your body may not have as much water and fluids as it needs. Some fistulas may not cause symptoms. Other fistulas cause intestinal contents to leak through an opening in the skin.

Which food is good for fistula? ›

Patients suffering from fistula should drink plenty of water and add food items rich in fibre to their daily diet. Make some changes in their food habit and in addition, they can inculcate the following: Cereals: Cereals include a wide array of food items like broken wheat, quinoa, brown rice, ragi and oatmeal.

How many times can fistula recur? ›

The total rate of recurrences was 15% (n = 14). Table 1 Results. In a total of 13 mucosal advancement flap operations, there were 3 recurrences with a recurrence rate of 23% in a mean follow up period of 80.2 months. In a total of 7 anal fistula plug operations there were 3 recurrences with a recurrence rate of 42%.

What are the chances of a fistula returning? ›

The chances of recurrence in different types of anal fistulae range between 7% and 50% [16-18]. Therefore, most patients require multiple surgeries. Due to a high failure rate in fistula operations and increased risk of recurrence, this condition needs to be studied in detail.

Videos

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3. Piles Surgery Recovery: How long does it take? | Dr. Kiran Shah by Apollo Spectra Hospitals
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