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Colorectal Diseases

Still having issues after fistulotomy

06/27/2008

Question:

I had a peri-rectal abscess drained in December 2007. After the site healed I still had blood and mucus leaking from the area. After many times of a bump coming up and then draining and healing the Doctor decided that he needed to perform a Fistulotomy.

He did find a fistula and said that he drained it. For the first few days after the surgery I started noticing that I no longer could control my gas. It would just happen and I never knew when it would. I spoke to the Doctor and he said that was normal due to the swelling and it would soon go away. Well..... I had the surgery on February 15th 2008 and I am still having problems with the gas. I also have problems with fecal incontinence. If I feel the need to go there had better be a bathroom close because I can no longer hold it. Also if I sneeze or cough hard I will have an accident. He said that this is normal and it can take 4-6 months post op for everything to go back to normal.

On my last post op visit he did a digital exam and said that I still have internal swelling. I am still very sore back there.... the incision appears to be healed except for a small spot on the anus. Over the past few days I have had some bleeding and it has been itching.

Do I need to seek a second opinion? Since I`m still having problems, does this mean that there is still some underlying issue that I am going to need surgery for?

Answer:

There is always a risk for some degree of incontinence with a fistulotomy- whether it is leakage of gas or stool. Your ability to control may improve a bit as swelling from surgery goes down, and can take up to 6 months or so.

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati