Intestinal Fistula

An intestinal fistula is a fistula that begins from the intestine. They are commonly formed as a complication of an injury or surgery. 

There are conservative approaches to manage the fistulas by controlling infections associated with them but in most cases (especially the high-risk patients), Surgery is required to remove all the infected tissue and debris to completely treat it.

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Intestinal Fistula

A fistula is an anomalous communication between two surfaces. Fistulae are named according to the organs or surfaces connected. 

An intestinal fistula is a fistula that begins from the intestine. Through fistula formation, it can connect to multiple organs or surfaces. It is not a condition on its own, rather a complication of certain conditions.

Causes of Intestinal Fistula

Intestinal fistula is commonly formed as a complication of an injury or surgery. Their common causes are:

  • Surgical procedure: It is dependent on factors such as surgeons' skill, patient population, the disease for which the patient is undergoing the surgery, and the complexity of the surgery. 

Surgical procedures are responsible for 50 percent of the intestinal fistulae formation.

  • Diverticular disease: Complex diverticular disease (formation of small bulging pouches in the digestive system lining) to contribute commonly to the formation of the fistula with an intra-abdominal organ such as the bladder. 
This happens because of the erosion of the diverticular wall and factors causing inflammation. 
  • Crohn's disease: It is an example of inflammatory bowel diseases, which to are responsible for intestinal fistula formation.
  • Malignancy: Intestinal cancer or cancer of the adjacent organs contributes to fistula formation. 
  • Radiation: A portion of the intestine undergoing radiation treatment over a period of time with delayed recovery and slow healing, is susceptible to fistula formation. 

Non-surgical injuries and the presence of foreign bodies: These involve injuries acquired in abdominal trauma of some kind tend to increase the chances of fistula formation.

Symptoms of Intestinal Fistula

Depending on the organs impacted and involved in fistula formation numerous symptoms come into interplay, such as:

  • ​Abdominal pain
  • Fever
  • Diarrhea
  • Gastrointestinal bleeding
  • Weakness
  • Loss of appetite
  • Weight loss
  • Extreme weight loss and muscle wasting (cachexia)

When other adjacent organs get involved in fistula formation, the following symptoms are added to the list:

  • ​Urinary tract infection
  • Fecaluria
  • Vaginal pain, discharge, or repeated infections

In cases where the skin gets involved in fistula formation:

  • ​Pain in the area of skin involved in fistula formation.
  • Irritable skin

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