What Is An Intestinal Fistula?
An intestinal fistula is a passageway or tubular connection between the intestine and another organ or the skin. The word fistula comes from the Latin, and means a passage. An intestinal fistula then is a passage that under normal circumstances should not be there.
A fistula is often an abnormality caused by some type of disorder, usually an inflammation of one type or another, but some fistulas are intentional, a surgical solution when a bypass path is required for the intestine. Fistulas are not restricted to the intestines alone, and can occur in many organs in the body. Intestinal fistulas however tend to be among the most common types encountered.
An intestinal fistula is often either the result of a condition called Crohn's disease or a condition such as ulcerative colitis, and is sometimes associated with irritable bowel syndrome. If inflammation of the inner lining of the intestine is confined to the inner lining, a fistula will not form, but if the inflammation extends through the several layers of the intestinal lining, resulting scarring or fibrosis can cause tissue destruction and the building of the fistula passageway which may tunnel through the outer layer of the or the skin.
As dreadful as an internal fistula may sound, it will not necessarily cause any symptoms and, depending upon the nature of the fistula and the organs involved, may or may not require treatment. The administration of antibiotics will often not only inhibit further growth of a fistula but will often cause it to heal and disappear, although once medication has ceased the fistula may eventually return. When medication fails, or an intestinal fistula exhibits very severe symptoms, surgery is sometimes necessary. If surgery cannot close the fistula, a portion of the involved intestine may need to be removed.
Sometimes Created On Purpose - An intestinal fistula is not always a bad thing. There are times when a fistula is created on purpose through surgery. If the intestine has become badly damaged, ulcerated by disease or a malignancy needs to be removed, it may be necessary to create a fistula from the intestine to the skin to allow for the passage of feces, and sometimes urine. In some instances, rather than creating a fistula, the intestine itself is routed through the abdominal wall to the skin so waste can be released from the body. This type of procedure is known as a colostomy. A colostomy may be permanent or temporary. This rerouting, when temporary, is often accomplished to allow a damaged or diseased portion of the intestine to heal, after which the passageway is returned to normal. In cases of colorectal cancer, the rerouting of the intestine may be permanent.
A Worst Case Scenario - Fistulas can occur in multiples and they will sometimes open and close unpredictably. An intestinal fistula can be quite painful if it connects between adjacent loops in the bowels, allowing the contents of the intestine to bypass segments of the intestine all together. If fistulas of this type open, then close, the contents of the intestine may become trapped, and the contents can be come infected and form an abscess. Such a condition can become quite serious if unattended, with one possible outcome being blood poisoning.
A Fistula May Be Difficult To Detect - One of the difficulties in dealing with intestinal fistulas is that, unless they are creating pain or discomfort they may go undetected until such time as the symptoms become rather severe. Even an examination, be it by barium X-ray or a colonoscopy does not always detect the presence of a fistula, and may miss one or more it there are multiple fistulas present.