This topic is about a person who experienced a severe rectovaginal fistula due to Crohn’s disease, which led to the creation of a permanent ostomy. They are reaching out to hear from others who have had similar experiences. Here are some insights and advice shared by others:

1. Emotional support and perspective:
- Many people emphasize the importance of emotional support, noting that mental and emotional healing can take longer than physical recovery. Keeping hope and believing in oneself is essential.
- Simple acts of kindness, like a warm smile or a kind word, can significantly aid in the recovery process.

2. Shared experiences with rectovaginal fistula:
- One person shared their experience with a fistula that developed after childbirth. Initially, it was a small gas-only fistula that worsened after a second child. Surgical repair helped with solids leakage, but minor gas passage continued until a colostomy was performed, which resolved the issue.
- Another person described a six-year history with a rectovaginal fistula, with multiple unsuccessful repairs. They recently had a colostomy and are waiting to see if a reversal is possible.

3. Surgery and healing observations:
- A layered transvaginal/transrectal closure can be effective for moderate-sized fistulas, though it might leave small residual tracts.
- Sometimes, a diverting stoma, such as a colostomy or ileostomy, is necessary to allow the fistula sites to heal, especially if previous repairs have failed. Reversal is considered if healing is successful.
- Complex rectovaginal fistula repairs often require collaboration between colorectal and plastic surgeons.

4. Coping resources:
- A recommended book is “Kitchen Table Wisdom” by Dr. Rachel Naomi Remen, which contains essays on hope, faith, and healing. The author herself lives with Crohn’s disease and a colostomy.