Caring for Multiple Fistulas Under a Barrier - Need Advice!

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Suz2

I posted before about an ulcer on the skin/stoma scar but that ulcer is now a fistula. I saw my surgeon today about it and he was focused on a small red dot about 1 1/2 inches from the fistula toward my belly button. He used a very thin instrument with rounded ends to poke at it and popped it open and found it tracked back to the first fistula. I now have 2 fistulas. And the second one is sore and irritated and I have no idea how to take care of it.

I can fit the barrier to accommodate the fistula on the stoma but I don't know how to handle the second one.

The second stoma is still under the sticky part of the barrier but toward the outer edge. I don't have any idea what to do. Do I cover it with the barrier and hope for the best? Should I cut the outside edge and cover it with a bandaid that I can change often throughout the day as needed? HELP!!!

My surgeon started me on Flagyl and Cipro today and called my GI. I have an appointment with my GI next Thursday to discuss changing my medication which should help heal them up. I've had many rectal fistulas since my first in 1986 that was dealt with surgically. I have used Remicade for fistulas in the past but developed a systemic yeast infection so it's not an option.

I REALLY need suggestions on the best way to deal with 2 fistulas so far apart but still under the barrier. The new school year is starting next week and I go back to work. I need to be able to deal with this while I'm working with my students.

Thanks so much!

Past Member

Wow, I am so sorry. I don't have any suggestions but have empathy for what you are going through. I don't understand the surgeon not having helpful suggestions. Hopefully the doctor next week can do something.



On the second one fistula - can you cut a hole and leave the area uncovered? Or do I just not understand.



Let us know - please.

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WOUNDED DOE

Hi sweetie....I know what you're going through....Remicade has been one of the best things available to actually heal and close fistulas, however it is quite the risky medicine, yowza....I am currently going through a tough choice of deciding if I will go back on Remicade or not because once off the meds for awhile, our chances of severe reactions are MUCH higher....the other best opt for fistula's is surgery repair.........let us know what your GI says and what you decide dear, keep us informed and good luck !!

Suz2

Hey Dawneagle and Wounded Doe.

I don't know if I can cut a hole for it or not. I think I'm going to try and see what happens. The surgeon wanted me to take Remicade but I can't go back on it because we stopped it several years ago because of a systemic yeast infection.

I started on Remicade back when it first came out because of fistulas. They seem to be a major part of my life! LOL! I had my first fistula repair surgery in 1986 then a couple more times after that before Remicade came out. I started Humira about 4 years ago and was on it for 2 years until my ostomy surgery. So now my Gi has to figure something else.

Of course this is the first time I've had to deal with fistulas of the abdomen. Used to them on my butt!!! LOL!!! The feeling is the same either way when you're having a bowel movement. Just on the front side instead of the backside! I need to remember to get more stool softeners while waiting for the Flagyl and Cipro to start working. Hopefully they'll start healing them and give new new medication a good start.

WOUNDED DOE

Oh my gosh, I forgot to mention something in my last post.... I had a tiny fistula in the past that was under the tape part of the pouch, similar to what I am hearing from you..... I have my own little home remedies and natural ways of trying to deal with things as often as possible and experiment on my own.... I have aloe vera plants, and what I did was I snipped off an inch-long piece of the aloe vera plant, sliced it open with a paring knife. It is gooey inside. Then, with my pouch off, and after cleaning and drying the site, I put the tiny opened slice of the aloe vera plant GOOEY SIDE DOWN over the fistula hole, then placed a bandaid over it to hold it in place. THEN, applied the new pouch with the appliance tape, of course, covering right over the top of the bandaid...... The aloe vera plant is well known for its healing abilities, both internally and externally, and they make GREAT poultices for many ailments from burns to wounds..... But after approximately a month of doing this, the hole on the skin closed..... Though, the tunnel from the fistula inside was still there, and I still felt a bit of burning sensations for a while........... But also, there have been times when my stoma was getting blotchy and dark in color and inflamed, and I would squeeze or 'bathe' my stoma in aloe vera juice straight from the fresh plant, then put the new bag on, and there was actually improvement................. Now please keep in mind, everyone is different, so what works for one might not work for another............ I am not a nurse or doc, nor have I ever been told to do this by anyone in the medical profession.......... This is just my own way of experimenting with natural healing methods.......... And it helped to some degree.

 
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Suz2

Thanks, Doe. I'll have to get me an aloe plant. The barrier was really bothering me Friday so I decided to change it and the 2nd fistula hole was quite a bit bigger. Went from pinhead size to almost dime size. I called my primary care doc and she saw me right away. We figured out the best way to wear the barrier and leave the 2nd fistula open and pack with gauze because it's still draining. I'll try putting aloe on the exposed fistula. Maybe that'll keep the hole from getting larger and protect the skin around it.

Now I need to figure out how to keep any odor down. School starts back this week and I go back to work and kids notice everything! LOL!

Gus

I had the same problem with two fistulas under the flange of my ostomy. My surgeon suggested filling them with the paste you put on the flange to help it seal. Just pump a small amount into the hole until it's full. This will stop any infection from growing and will allow the fistulas to heal from the bottom up. I know it sounds strange, but it worked for me and within three weeks they had gone from being two holes half an inch round to just a slight depression fully closed up. I hope this works for you. Now you see why I want to be a stomal nurse.

Suz2

Hi, guys. Would that work if there's still stuff coming out of the hole? When it was covered by the barrier, it became worse and was full of stuff. I'm afraid if I close the hole on the outside, I'll end up with an abscess. The second fistula runs over 1 inch to connect to the first fistula, and I don't know where it ends. How do you get the paste out? Thanks, Gus.

Past Member

Hi Suz2,
I had a sore on one side of my wound, which they think was a very superficial fistula tract approximately 3 months after my surgery. I was told by the ET nurse to use some Aquacel Ag dressing and a hydrocolloid dressing on top of it. If your insurance doesn't pay for these dressings, you can find them on eBay cheaper, just check the expiration dates on them. You just cut a little square of Aquacel Ag dressing to fill the wound where it's draining (make sure it doesn't get 'lost' in the wound though). In other words, leave a tail hanging out so that it can be easily removed. Then cut a bigger square of hydrocolloid dressing (she rounded the corners off a bit of the hydrocolloid) to place on top.

The Aquacel Ag has an antimicrobial fighting agent which helps ward off infection, then the hydrocolloid is kind of like the "Band-aid" on top that keeps the moisture in and protects the wafer seal. The Ag dressing will be gelled like when you remove it. It absorbs any drainage. While I had this wound though, I had to change my appliance on a daily basis.

Another thing I think helped was I started back taking what I call the "healing" vitamins they gave me after surgery, which were A, C, and zinc.

Gus
Drain the holes by manipulating the skin around them. Then fill the holes with paste. As more exudate is formed in the holes, it breaks the paste down and it should come out when you change the flange. If not, use gauze to wipe it out. The holes should start to fill in.

Because they have somewhere to go, as in out towards the skin, and because the glue breaks down, they should heal okay. It's worth a try. Mine were about an inch in depth too where they connected. See how it goes.
Suz2

Thanks, Gus. I'll give it a try. I was wondering how you got the paste out and didn't end up with an abscess. The first fistula looked like it was still getting smaller when I changed my barrier two days ago. The second one still has drainage. I started back to work yesterday for the new school year. This might be the way to go to get through the day easier.

WOUNDED DOE

Anyone ever have the entire fistula tunnel heal by itself completely?????



I have active Crohn's on just the last few inches of my intestine with a new teeny fistula between the stoma and the skin surrounding it. And though I do things to help control it a bit topically again and it's better, I worry about what is tunneling inside me that I don't know about, if anything....yowza....sooooo, I am talking to a surgeon to see about just having it surgically fixed....I'd rather go under the knife and have them get rid of the problem. I am not patient enough to deal with anything too long lol.....I love hearing what others have to say about all our experiences xoxo

Past Member

Wow, I never realized that fistulas were such a damn common thing. I suppose after having my ileostomy problem-free for 11 years, it made me pretty complacent. I forgot just how much inner strength it takes to deal with all this... Good luck and will keep you posted on my outcome.

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