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Flap advancement - how can you tell if it fails?

flap advancement

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#21 elimfree

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Posted 05 February 2015 - 12:39 AM

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Hi,all

 

I had Advancement flap & fistulotomy on Jan 14, 2015.  

 

still, some gas passing thru perineal opening & have  pain.  but, Pus is almost gone. They fixed perineal opening and anal opening (I had one inside fistula and two out side opening) that sigh is no good? 

 

 

 

Please,help me.

 

Thank you




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#22 elimfree

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Posted 16 February 2015 - 01:18 AM

Hi all

 

still, gas passing thru perineal opening but, doc said that my flap is working and there is no hole and infection.

 

 

pls advice me.



#23 healthquest

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Posted 29 May 2015 - 11:50 PM

elimfree, how are you doing now? I just noticed that you were only one month post op when you posted in Feb. I hope all went well.

 

Re anyone who has just had surgery and are reading this thread, try not to prematurely worry. Give yourself recovery time. One month is very early in the recovery....

 

My brief update almost 1 1/2 years post op:

Travel is difficult on my routine especially when eating restaurant meals. What I have come to realize is that I must be vigilant and rigorous with my diet. I think that is how I got the fistula in the first place - chronic constipation. I attempt to avoid that at all costs.  So far no recurrence, grateful for my recovery.  



#24 AFS

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Posted 31 May 2015 - 12:39 AM

Can not agree more with healthquest on diet. Constipation and stress are main causes, IMO. These days, I pay great attention to the food I eat and its effect on my BM. 


Abscess Fistula Sufferer (11/2013 - 05/2015)

https://fistulapatie....wordpress.com/


#25 wmfwall

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Posted 13 June 2015 - 09:13 PM

Hi I just had a recent endorectal advancement flap but my CRS didn't prescribe any antibiotics. Is this normal? I would think that having sutures down there with fecal matter would cause infection rather quickly. Thank you.



#26 healthquest

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Posted 14 August 2015 - 07:13 PM

I don't think antibiotics are helpful. Your whole colon is full of bacteria and killing off the good bacteria is all that would be accomplished. I asked a friend who is a Medical Microbiologist about this and she said there is really no place for antibiotics in fistula issues. It is pretty much strictly a surgical situation.  Sitz baths with salt is a really good way to keep the area clean. 



#27 AFS

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Posted 15 August 2015 - 12:02 AM

Folks, Please read my story of struggle and final cure. The treatment I underwent can help those suffering from high anal fistula.

 

https://fistulapatie....wordpress.com/


Abscess Fistula Sufferer (11/2013 - 05/2015)

https://fistulapatie....wordpress.com/


#28 elimfree

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Posted 28 August 2015 - 05:06 PM

healthquest :

hi..

 

10 days ago. I just had my martius flap (that is my 3rd surgery)  (August,19  2015)

 

 

when first advancement flap they didn't closed my perineal opening. (jan, 14  2015)

 

and anal fistula (infection) is gone but still has tiny hole there so it connect with my perineal. 

 

it passed gas and some poo poo  ( not a lot but, i know )

 

 

7days later from martius surgery (on 8/26)

 

I have some discharge and bad small ( that smell is same as my anal fistula pus)

 

email to doctor and he gave me antibiotics  (on 8/27)

 

and I found out there is still hole. 

 

my doctor said it is ok and wait to heal my body

 

 

 

what happen to me ;(

 

I just want to back my normal life.

 

around 1 year , I didn;t do anything  I almost lost my husband and my life.

 

 

pls, help me.



#29 Gitts

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Posted 03 November 2015 - 01:56 PM

I had y second advancement flap two weeks ago

I have a question on faeces in the outside opening. I went to ee the doctor and he romeved sutures saying that is what was making it accumulate. however the faeces still accumulate and now there is pain. The sitz bath has stuff floating around too.

anybody had a similar experience?



#30 Medic85

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Posted 17 July 2017 - 10:53 PM

It's been a couple years since the last update, but since I've found this thread so helpful, I wanted to share my story and hopefully receive updates from you guys.

 

My story first began about 10 years ago. While at college (I blame dining hall food and cheap toilet paper) I developed a fistula without an external opening. After about 2 years of denial, while dealing with discharge and pain, I finally went to a colorectal surgeon and had a fistulotomy to repair it. It seemed to work, and for two or three years, I was pain free.

 

Then I started to develop some chronic pain in the area of my tailbone. I saw several doctors and had X-rays be the consensus was that I may have a tailbone dislocation. Unfortunately, there weren't many treatment options available. Fast forward a few more years. The pain got worse and worse, but I didn't think I had any treatment options available. Finally, this year, I decided I couldn't live with the pain anymore, so I saw a spinal specialist who sent me for an MRI. His conclusion? I had a massive fistula extending all the way to my tailbone. The pain I felt was fluid build up and pressure. There was additional fluid along my spinal column that wasn't draining because of the fistula. Time to head back to the colorectal surgeon.

 

It looked like the same fistula from my youth was back with a vengence. My surgeon performed an exam under anastesia, but ultimately referred me to another surgeon who specialized in the mucosal advancement flap procedure.

 

So, since there was no external opening, first step was Seton placement. That was fairly straightforward. A bit painful at the incision site, but after a couple days I was back to work. After almost two months with the Seton, with continued drainage, I accidentally broke the Seton and pulled it out, along with a couple internal stitches. Luckily, my surgeon said that since the drain had been in so long, it should remain open without the Seton and everything would be okay.

 

End of June I had the advancement flap. I definitely underestimated how much pain and disconfort I would be in. It took a solid two weeks before I was mainly pain free. However, 6 days after my surgery I began having extremely heavy bleeding following a bowel movement. The bleeding wouldn't stop, and eventually I could no longer even stand up to go to the bathroom. I was way too lightheaded. I ended up in the Emergency Room, with a blood pressure of 84/52 and was rushed to the trauma room to receive a couple large bore IVs and other treatment to stabilize me. I had lost a lot of blood and my hemoglobin level dropped from a 14 to a 9.3. Yikes.

 

However, somehow, it seemed like throughout all this, my flap held. By the time I was discharged two days later, drainage had dropped to almost nothing. Amazing! Since then, it has resumed as I've tried to walk a bit and be more active, but right now, at almost three weeks since the surgery, I'm still lying low and trying to stay off my feet as much as possible. The pain has mostly subsided and I'm thinking about going back to work part time, light duty, later this week. Now it's just a waiting game. Is this thing actually going to work?? It's been so long and I feel like I've invested so much time and hope into this surgery.

 

As I've said, the stories on here have been really reassuring. Im going to continue taking it easy and give myself the best chance of healing, but I've heard that I really won't know if this worked for another two months! Let's hope for the best!



#31 Lubica

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Posted 21 August 2017 - 08:44 AM

Hi Medic85,

 

looks that you are the only one after few years who is active now.

 

I ve been reading this site several times after my surgery when I had any doubts about my healing.

 

Please note I m not a native speaker so my English will be simple.

So my long story short...

 

I ve been on 5 surgeries all together. In my case it started with inflammation of bartholins gland as a gynecologic problem. it was in 2014. The gynecologist extracted it but it was really deep and complicated. Treatment took really long time. I was not able to sit comfortable at least 4-5 months. After one year inflammation was back. surgeon thought that it just did not heal properly so he cleaned it again...again pain and treatment. But after 10 months the same story and another surgery.

 

Just in the end of last year when it happened again I had the feeling it is not just about the old wound but I had the feeling that it has connection to anal.

 

After several examination and MR I found the specialized surgeon. During the surgery he confirmed that it is perianal fistula communicating between old wound and anal (that's why it was never healed properly before).

So it was in January. He cleaned fistula and made ligature (do not know if it is right word in English. basically he inserted tiny thread going through the fistula. As I understood the purpose was to heal it just thickness of the thread). The next step was advanced flap surgery. It was done in May this year.

 

Have to say that I thought it will be less painfull. I thought that the first one was more difficult...but first two weeks were horrible. went to the toilet with tears in my eyes.

 

After more that 3 months it is still not healed properly. It pass gas and discharge after using toilet. I went to the doctor before two weeks and he inserted the thread into fistula again. Hoping the connection became less wide.

 

Nevertheless I still have some hope that it will heal. Making baths with herbs. Also my doctor said when I went for holiday that sea is really good for healing. So I continue making baths also with salt. And in 3 weeks go for another holiday. So hope It will help again. At least for psychic.

 

Now I am trying to find any recommendations. I read that the food is really important. Less sugar and also carbohydrates, lot of vegetable. Also I am trying to find some info about Ayurveda. From medical point everything what was possible was done. So now I am thinking to go more natural way. To make body more powerfull to fight with inflammation. At least I can try it :)

 

Despite I do not know if it will be healed I am trying to live normally if it is possible. Going for holidays, festivals... For last years I missed a lot of things because of the fistula. Do not want to do it again.

 

Reading your story I can imagine how you feel. But it will be better and better day by day. Hope that you are the lucky one and advanced flap will help you finally.



#32 healthquest

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Posted 02 December 2017 - 11:51 AM

Hello All,

 

It is hard to believe I started this post four years ago. I want to start off with a message of hope...I am fistula free and have had no further treatment after the advanced flap.  I did have a small set back a year ago. I went to my doctor as the fistula site had started to flare, itch, become painful and burst with a small amount of blood. Then it would heal for several weeks then the pattern would repeat. Not a lot of blood but my doc back on a surgical wait list. I could not believe it. Keep reading....I found out why this was happening!

 

That day at the doctors, I also spoke to her about another problem. A work situation that was really stressful and was not going to improve (Narcisstic colleague). I was in leadership in Healthcare and had 25 years with that employer, never one work problem, never one bad performance review. When my doctor heard all the awful stuff I was living through she said: "[color=#0000cd;]you must leave that job and you are never going back, these people hide out in big organizations like government [/color][color=#0000cd;]and[/color][color=#0000cd;] Healthcare. [/color][color=#0000cd;]If[/color][color=#0000cd;] she has targeted you, the only thing you can do is escape"[/color]. And that was that, I never returned to work. I will admit my whole self care regime was badly off track during this period of increasing psychological damage leading up to me walking away from that horrible situation. 

 

The interesting part of this story is after removal of the work stress, I started focusing on the diet, stress reduction, yoga etc and guess what?.... the fistula reopening miraculously healed itself within a month. That was 11 months ago.  Don't underestimate the effect of stress health issues like this, anxiety, insomnia, IBD. I walked away from a very high paying job but for once in my life, I put my health first. I now have a much better job and all the stress related stuff is gone. I feel like a normal human being. My doctors eyes popped when I said it just healed. She said "well doesn't that tell you something."

 

Re romance and fistulas...this is never spoken about. For those still suffering, for goodness sakes don't make this a reason to avoid sex. Don't be self-conscious with your partner, it probably bugs you a whole lot more than it bugs them. Plan a relaxing bath with candles and then just live your life to the fullest. Don't let the fistula ruin your happiness, it does not have to. The only time I avoided sex was for about a month post op back four years ago. 

 

I have not been on the forum for a very long time.  I am glad to see it is still active and helping people.  AFS, congratulations on your successful treatment as well. Thank you for the link to your blog. 

 

Sending out good thoughts of healing and happiness to wherever you may be on the planet. Be well, 

 

Healthquest



#33 staypositive

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Posted 14 December 2017 - 01:47 PM

Hi I'm on my 5th week post op of the AF fistula surgery. The drainage has gone down a lot now but still have gas passing from the external opening. The gas pass started on the second week after the post op when I had some infection and had some abscess built up in the tract which burst by itself after antibiotics. Saw the surgeon twice already and he just asked me to wait. 

just wonder if anyone had similar gas passing issue. Did it eventually go away? How long does it take? I'm a bit nervous now. Thanks.



#34 healthquest

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Posted 30 December 2017 - 06:56 PM

Hi I'm on my 5th week post op of the AF fistula surgery. The drainage has gone down a lot now but still have gas passing from the external opening. The gas pass started on the second week after the post op when I had some infection and had some abscess built up in the tract which burst by itself after antibiotics. Saw the surgeon twice already and he just asked me to wait. 

just wonder if anyone had similar gas passing issue. Did it eventually go away? How long does it take? I'm a bit nervous now. Thanks.

 

Hi Stay Positive, I like your user name.

 

Constipation, diarrhea and gas are not normal and these issues must be addressed. Some naturopaths run breath tests for SIBO (small intestine bacterial overgrowth). I was tested and treated for this and now I have normal bowel movements. Gas passing through channel means that there is likely NO localized infection so no reason to worry about the surgery having failed. I am not an expert but I remember thinking no drainage or no increasing drainage is a good sign. It takes time for the body to heal and completely close up the area.

 

Best of luck!

 

 



#35 staypositive

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Posted 02 January 2018 - 01:56 PM

hi healthquest, thanks for your response and thanks for starting this thread four years ago. It has helped many fistula patients.

just to share some quick updates, the draining and gas passing finally stopped in the middle of week 5 post op, so that was a huge relief. I saw the surgeon last week (week 6) and he was pleased to see the healing progress. The external opening has closed for about 2 weeks, and I do not have any obsesses, which is a good sign. I can still feel the tenderness inside after BM, but it is also getting better. So I consider the AF procedure a success on me, although I'm still cautious on what I eat which I think is the root cause of the whole nightmare.

I have been taking fruits and bene fiber everyday and some probiotics a couple times a week. So far the BM has been normal. I had a breath test for SIBO a couple years ago and results came negative.

Hope all the ones suffering the fistula have a fast recovery and try to be patient with the post OP thing. It takes a long time. 

Happy New Year!



#36 healthquest

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Posted 12 June 2020 - 11:00 PM

Six years later and I am still feeling great with no relapses nor need for further treatments or surgeries. I just had bloodwork done this week. Back when I was really in a distressed situation, my ferritin was less than 15 so I had iron deficiency from blood loss in my GI. This week my ferritin was 80, a big increase that corresponds to a lot more energy. Also my inflammation markers were really low, also an improvement. 

 

Maintance wise, I still try to avoid gluten and dairy. The dairy is harder to achieve. I found a new online diet planning program here https://realplans.com that makes it pretty easy when I want to do a few weeks of Autoimmune protocol diet AIP. 

 

I try to guard against any constipation and now add flax or PGX supplements to my diet from time to time. When I do this, I pour a big jug of water and sit it on the counter. I make sure I drink all of it. 

 

I want to update this post every few years and send caring thoughts to everyone who is suffering from unspeakably awful GI issues. Don't let it stop you from living life. 

 



#37 healthquest

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Posted 12 June 2020 - 11:03 PM

hi healthquest, thanks for your response and thanks for starting this thread four years ago. It has helped many fistula patients.

just to share some quick updates, the draining and gas passing finally stopped in the middle of week 5 post op, so that was a huge relief. I saw the surgeon last week (week 6) and he was pleased to see the healing progress. The external opening has closed for about 2 weeks, and I do not have any obsesses, which is a good sign. I can still feel the tenderness inside after BM, but it is also getting better. So I consider the AF procedure a success on me, although I'm still cautious on what I eat which I think is the root cause of the whole nightmare.

I have been taking fruits and bene fiber everyday and some probiotics a couple times a week. So far the BM has been normal. I had a breath test for SIBO a couple years ago and results came negative.

Hope all the ones suffering the fistula have a fast recovery and try to be patient with the post OP thing. It takes a long time. 

Happy New Year!

 

Stay positive, if you ever circle back to this forum let us know how you are now.  I know that if you haven't posted, you are probably doing great!







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