How do fistulas occur

This content does not have an English version. This content does not have an Arabic version. Overview A rectovaginal fistula is an abnormal connection between the lower portion of your large intestine — your rectum — and your vagina. A rectovaginal fistula may result from:. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references deBeche-Adams TH, et al. Rectovaginal fistulas. Clinics in Colon and Rectal Surgery. Champagne BJ, et al.

Rectovaginal fistula. The Surgical Clinics of North America. Tintinalli JE, et al. Anorectal disorders. New York, N. Accessed Nov. Whilst in hospital, the team may replace the salt and fluid using intravenous fluids or you may also be put on Trans Parental Nutrition TPN which means you will receive all your nutrition through a central line.

This will ensure you get all the essential nutrients required amongst other things to facilitate healing, whilst resting your damaged bowel. But like everything, there are massive down sides. I have been on it a few times for a few months at a time. Some people are never able to come off it. Leakage from a fistula can be a distressing experience.

The same enzymes in your gut that will digest a juicy steak will make contact with your skin and cause it to become excoriated , which means very red and sore with the skin breaking down just like that piece of meat.

It is very painful and prone to infection which makes a bad situation worse. Therefore fistula care by the ward nursing staff, led by a specialist stoma nurse, is vital in preventing these problems. Medication may also be used to reduce the output and acidity from the fistula. You will see a stoma nurse when in hospital and a plan of care will be put in place for the ward nursing staff to follow.

Once discharged you will have access to a stoma nurse if any problems arise. They will occasionally do home visits if necessary or you can go to the hospital. The ongoing management of a fistula depends on so many factors. Some people will have their fistulae repaired by undergoing more surgery. Unless faced with an emergency situation, there is usually a wait of at least 12 months before this can be attempted.

Some people will have to continue to receive nutritional support at home Home Parental Nutrition or HPN through their central vein as the damage to the gut is too great and normal nourishment would mean essential nutrients would be lost resulting in malnourishment.

In other words the food and waste would come out of the fistula before giving the bowel the chance to do its job — absorb all the nutrients and fluid from what we eat and drink. It depends of course on where in the bowel the fistula is. HPN tends to happen more with a fistula that is high up in the bowel, this usually means the fistula output is high as much as several litres per day.

Injury can cause fistulas to form between arteries and veins. Abdominal abscesses and gastrointestinal fistulas. Philadelphia, PA: Elsevier Saunders; chap Lentz GM, Krane M. Anal incontinence: diagnosis and management. Comprehensive Gynecology. Philadelphia, PA: Elsevier; chap