What is a fistula? Learn about symptoms and types of fistulas. - National Association For Continence (2024)

Fistula Definition: A fistula is an abnormal connection or passageway that connects two organs or vessels that do not usually connect. They can develop anywhere between an intestine and the skin, between the vagin* and the rectum, and other places. The most common location for a fistula is around the anus.

The majority of fistulas are idiopathic, which just a fancy way of saying that their specific cause is uncertain. However, it’s worth noting that a significant number of them are associated with Crohn’s disease and other inflammatory conditions. In fact, about 25% of people with Crohn’s disease will develop fistulas.

ANAL FISTULAS/PERIANAL FISTULAS

Anal fistulas are abnormal connection between the epithelialized surface of the anal canal and the perianal skin.

• Anorectal fistulas occur between the anal canal and the skin around the anal opening.
• Rectovagin*l or Anovagin*l fistulas occur when a hole develops between the rectum or anus and the vagin*.
• Colovagin*l fistulas occur between the colon and the vagin*.
• For a detailed discussion of anal/perianal fistulas, click here.

These are abnormal openings within a urinary tract organ or an abnormal connection between a urinary tract organ and another organ.

• Vesicouterine fistulas occur between the bladder and the uterus.
• Vesicovagin*l fistulas are where a hole develops between the bladder and the vagin*.
• Urethrovagin*l fistulas are between the urethra and the vagin*.

• Enteroenteral fistula occurs between two parts of the intestine.
• Enterocutaneous or Colocutaneous fistula occurs between the small intestine and the skin or the colon and the skin respectively.

Left untreated, fistulas can be traumatic, debilitating, and can do additional harm to your body. Nerve damage, infection, and kidney failure are associated with fistulas.

Learn more about fistula causes and symptoms, as well as ways to treat them in this comprehensive brochure. Click the image to download it for free!

The World Health Organization (WHO) estimates that there are 50,000-100,000 new cases of fistulas every year. In places like Africa, obstetric fistulas are often left unaddressed due to lack of obstetric care. Thankfully they’re somewhat less common in the United States, but with an estimated 200,000 cases, it’s still a significant number of people affected. The good news is that fistulas are often diagnosed early and cared for appropriately.

Prevention is the best treatment. Maintaining a good nutritional habit is a great way to maintain healthy tissue and to ward off fistulas. In addition, abstaining from smoking is important to promote fistula healing.

Depending on the type of fistula, here are some telltale signs you may notice if you have one:

• Constant urine leakage from the vagin*
• Irritation in the external female genital organs
• Frequent urinary tract infections (UTIs)
• Leakage of gas and/or feces into the vagin*
• Fluid drainage from the vagin*
• Nausea
• Vomiting
• Diarrhea
• Abdominal pain

If you have one or more of these symptoms, be sure to promptly discuss them with a healthcare provider.

In Africa, the most common cause of fistulas is childbirth and obstructed labor that is left unrelieved. While the incidence of fistulas due to complicated births is lower in the United States, other causes can create this troublesome condition.

Crohn’s disease and diverticular disease are well known to cause fistula formation. In addition, those who are undergoing radiation therapy are at greater risk for a variety of fistulas.

• Fibrin glue.A specific medicinal adhesive is used to seal fistulas.
• Plug.This is usually a collagen matrix used to fill the fistula.
• Catheters.Used to drain fistulas, catheters are usually employed on small fistulas to manage infection.

Antibiotics or other medication may also be used to treat any infection associated with the fistula. Yet there is no pharmaceutical solution to eradicate fistulas at this time.

While fistulas pose a serious threat to your body, high treatment success should encourage you or someone dealing with fistulas to seek immediate help.

• Transabdominal surgery.The fistula is accessed through an abdominal wall incision.
• Laparoscopic surgery.This is a minimally invasive surgery that involves a tiny incision and the use of cameras and small tools to repair the fistula.