What should I expect from a rubberband cutting seton to cure fistula?

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patsybell
New Member


Date Joined May 2010
Total Posts : 13
   Posted 5/14/2010 2:35 PM (GMT -7)   
Hi all -

Looks like one of my options to cure the fistula is to have a rubberband "cutting" seton. I was wondering if any of the members that have had this would mind sharing their experiences with me with regards to pain and pain management. I am a mother of 3 boys, the youngest is only two years old. I can't just be in pain, lay down, spend the day doing sitz baths for weeks on end. I'm trying to gauge how much the pain affects your life, because I have to be "on" basically 24/7 for my kids. It's OK if you can function with the pain, or if when they tighten the seton is really bad for a day or two, then my husband can take an occasional day off work to give a hand. But if not, I'm going to be in a pretty bad situation with the kids (unfortunately no family around... wish my mom where here.)

I'd really appreciate if you'd share your experience and what things you found to work for you.

Thanks,

patsybell

sweetnakira
Regular Member


Date Joined Apr 2010
Total Posts : 119
   Posted 5/14/2010 4:08 PM (GMT -7)   
Hello, I just got a rubberband seton put in on May 4th while I had a 5 day hospital stay for IV fluids and antibiotics. The surgeon never called it a rubberband "cutting" seton but it is a rubberband seton. I haven't had any pain at all from it and didn't even need any pain medication. I'm not sure if I have the same as what you will be getting. Mine is for a rectal fistula and it looks like I have a piercing (thats my little joke around the house). When it was first put in they gave me a sitz bath and peri bottle but I haven't had to use the sitz bath at all. If I have a bowel movement I just fill the peri bottle up with warm water and squeeze it to make sure the area is clean but now I just take a wipe and wet it with warm water and clean myself very good. I do have drainage and I wear a pad and change it every time I use the bathroom. I was very scared when I heard that I needed it because I was reading a lot of stuff on the internet about how people experienced so much pain but I can honestly say that I haven't had any at all, maybe a little discomfort the first couple of days but like I said I didn't even need to take a tylenol or anything.
37 year old female and a proud mother of 8 kids (5 still living at home) and a very supportive Husband
Found out I had crohn's disease about 3 years ago, I haven't had proper treatment since :-(
Have had rectal abscess and now a rectal fistula, Medications I have taken for crohn's is..... Asacol and Entocort EC......Currently taking....Asacol
Suppose to start Steroid and 6mp next week (May 18, 2010).....I'm so scared :-(
Seton drain was put in on May 4, 2010
I also suffer from very bad anxiety and panic attacks for over 10 years (after my father passed away)
I have tried almost every medication for it but nothing worked or I had a bad side effect so for the last 6 years have been on xanax 1mg., 3x's a day
I started having joint pain about 7 months ago :-(


hld4good
Regular Member


Date Joined Jan 2010
Total Posts : 193
   Posted 5/14/2010 8:58 PM (GMT -7)   
Ask the surgeon to explain how the cutting seton works in detail. It is different from a regular seton and it is good to learn all about how it works and how long it takes before you have it done. There are other members who had the cutting seton who may have more info.
Age 58, Crohn's since age 21
3 bowel resections, 1980,88,95
1 fistula repair, 2005
probiotic
digestive enzymes


patsybell
New Member


Date Joined May 2010
Total Posts : 13
   Posted 5/14/2010 9:11 PM (GMT -7)   
Hi sweetnakira. Thanks for sharing your experience. It's good to see a range, and it's good to see that the range starts at "no pain really". By the way, I noticed your signature about anxiety. Have you ever tried mindful meditation?

Hi hldwodrgs. Thanks for the advice. I sure plan to grill my new colorectal surgeon when I see her on Wednesday.

kccrohns
New Member


Date Joined May 2010
Total Posts : 4
   Posted 5/14/2010 10:17 PM (GMT -7)   
Hi Patsybell, I am not saying this to scare you, but I just wish someone had told me. In March I had a seton put in and the doctors said that it would be "no big deal" and that I would be able to return to my normal activities within 24 hours. This was NOT the case for me, I was in ALOT of pain and coming from a college student who has never missed a day of class, I missed 3 days because I was so uncomfortable. I think its a necessary procedure and bearable BUT it is so important that you are aware and maybe plan accordingly. Everyone is different and I have heard of alot of people who have minimal discomfort, I just wanted to let you know that there is a chance it could take a few days to feel better. Please let me know how it goes!

patsybell
New Member


Date Joined May 2010
Total Posts : 13
   Posted 5/14/2010 10:23 PM (GMT -7)   
Hi kccrohns - Thanks for sharing your experience. Looks like I need to plan for a few days of daycare after it's put in place. It also sound like it gets better afterwards, so this is quite hopeful.

seraphina
Regular Member


Date Joined Apr 2010
Total Posts : 39
   Posted 5/14/2010 11:06 PM (GMT -7)   
patsy,
 
I have a rubberband seton and it took me nearly a week to recover, but I think its because the knots pushed out of the incision site.  which it had been doing fine but i forgot to keep moving it once a day and I had to start again because it was starting to heal in place, so the pain feels almost as intense as when i had it put in place.  This is sad to say but i'm ready for the surgery just to get this thing out of me.  I know from what my doctor told me cutting setons they have to go in every couple of weeks and and take a type of surgerical threat and wrap abount the excess and sorta tighten it.  They don't want to do with mine since its a high fistula.   I have to say the baths as hot as you can take seem to help a lot, its a pain in the ass and right now I don't have to do it as much as it did and it was a pain i had to do one before work, one when i got home and one before bed and because i'm a germ a phobe, i would shower after each one because i figured i was just sitting in bacteria.  I did find this blog this guy had in Japan.  This link shows his seton after it fell out, you can see where they gradually tightened it, I would note this guy is in Japan so some things might be different but maybe it might give you and idea and obviously I would ask you doctor to explain it really in detail and ask about recovery and sucess rates etc., I have found in this little adventure its really important to educate yourself as best as possible.  Here is the link  http://web.mac.com/losguys/The_Mystic_Knights_of_Fistula-in-Ano/Ano_Blog/Entries/2008/7/20_Farewell%2C_My_Seton.html

patsybell
New Member


Date Joined May 2010
Total Posts : 13
   Posted 5/15/2010 7:51 AM (GMT -7)   
seraphina,

Thanks for sharing your experience. I hope surgery day comes soon for you or at least, the bad pain days are gone. And thanks for the link. The guy that wrote it is witty and at least I could laugh at the whole thing!

Howlyncat
Elite Member


Date Joined Jan 2005
Total Posts : 24909
   Posted 5/15/2010 3:36 PM (GMT -7)   
i wish you all the best too
keep us posted
lyn
..Co Moderator for Crohns........Alzheimers.....Anxiety/Panic

DX..Crohns,,,A/P...Fibro...Seizures..Neuropathy...Pyoderma Gangrenosum..Deaf
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sweetnakira
Regular Member


Date Joined Apr 2010
Total Posts : 119
   Posted 5/15/2010 4:18 PM (GMT -7)   
Hi patsybell, I have tried cognative behavorial therapy for the anxiety and panic attacks and it helps to an extent. Before the anxiety and panic attacks were so bad I couldn't leave the house but now am able to leave the house, as far as the anxiety, but the constant bathroom use from the crohn's is keeping me in the house now :-(.

As far as the people who had so much pain from the rubberband seton I am so sorry to hear that because I have one and it really doesn't bother me at all. The only time I seem to have discomfort is when I have a LOT of bathroom trips but otherwise I don't even notice it's there but do make sure I keep it clean.

Patsybell, keep us updated and let us know how everything goes. I hope you have a good experience with it like I have.
37 year old female and a proud mother of 8 kids (5 still living at home) and a very supportive Husband
Found out I had crohn's disease about 3 years ago, I haven't had proper treatment since :-(
Have had rectal abscess and now a rectal fistula, Medications I have taken for crohn's is..... Asacol and Entocort EC......Currently taking....Asacol
Suppose to start Steroid and 6mp next week (May 18, 2010).....I'm so scared :-(
Seton drain was put in on May 4, 2010
I also suffer from very bad anxiety and panic attacks for over 10 years (after my father passed away)
I have tried almost every medication for it but nothing worked or I had a bad side effect so for the last 6 years have been on xanax 1mg., 3x's a day
I started having joint pain about 7 months ago :-(


Iram
Regular Member


Date Joined Jul 2003
Total Posts : 145
   Posted 5/16/2010 8:15 AM (GMT -7)   
Several years ago I had the rubberband seton (cuttin setton) placed, it helped me a lot. At first it is very difficult and I was not able to sit at all and you constantly feel the pressure of the seton, but eventually you get used to it. I had two setons placed and eventually both of them fell-off without any effort. Sitz baths are the most effective, I spent a lot of time in the bath and moving your bowels the first few days and event the first few weeks are very difficult. Besides, you have to make sure that the area does not get infected. So you might be on antibiotics, stool softeners, immunosuppressents and maybe even prednisone, and sulfa drugs. A combination of these should be effective, you might also look into the biologic therapy to go along. I lost a lot of weight about 20 pounds or more and gave up eating greasy foods and coffee.

patsybell
New Member


Date Joined May 2010
Total Posts : 13
   Posted 5/16/2010 8:35 AM (GMT -7)   
Iram - Thanks so much for sharing your experience. I hope it helps me too.

Iram
Regular Member


Date Joined Jul 2003
Total Posts : 145
   Posted 5/17/2010 6:31 AM (GMT -7)   
Yup, patsybell, keep us posted and updated. Good luck with the procedure, it might require overnight hospital stay

positivehealth
New Member


Date Joined Mar 2015
Total Posts : 4
   Posted 3/6/2015 10:00 AM (GMT -7)   
Hello everyone,

I have read a lot of postings about Anal fistula, fistulotomy, procedure and recovery, and I am truly grateful for all of the information I was able to find online. Thank you!

I also want to share my experience to help others.

It was very helpful to read forums because I didn't know that much about the surgery. However, we also need to be careful because reading too much information or about bad experiences can also become confusing and even scary... balance is the Key!
I hope you can find below a good summary and maybe the answers to some of the questions you may have about this surgery or about the recovery.

For me and at first, I thought it would be a simple intervention and that I would be all good after a week or so but when I came back in the room after the surgery, the doctor told me that I had also a Seton in place (I didn't know what it was!) ...the medication was probably very strong because I didn't realize that much on that day what was a seton ;)

The next day I realized that this surgery was only the start of a recovery and it was better for me to learn more about it and go through it with the best attitude I could.

I had my fistulotomy with a cutting Seton placement almost 3 months ago and I can finally say today that it is now all OKAY. I SURVIVED :)

Now I feel very good and the recovery is 99% completed but the first 8 weeks were totally different (see more details below).

Fyi: You won't be feeling the seton that much after the first week or so.

TRY TO STAY POSITIVE. You will feel so good and proud once everything is finished.

I also find that there are more people posting about their negative experiences about anal fistula than people sharing good and positive experiences.

On this post, I would like to share with you a summary of the experience I had with my anal fistula surgery in order to help others that might be facing the same situation.

I think it is also important to remember and to always keep in mind that keeping a positive attitude in the most difficult times we may face in life, will help us going through it better and faster.

I think our Mental power/attitude can be our best tool and be very helpful in any surgery/recovery and keeping positive vibes will not only help us going through the recovery but will also help us to keep a happy life during the healing process.

DON'T WORRY, IT IS DIFFICULT IN THE BEGINNING AND AFTER THE SURGERY BUT SLOWLY AND SURELY YOU WILL START FEELING BETTER AND BETTER.

My suggestion & tips:

- Keep the area clean (Sitz baths (5 minutes) 3 Times a day + after bowl)

- Keep the area Dry after shower and sitz baths (Hair dryer if needed)

- Drink alot of water (6-8 glass of water)

- Take your prescribed pain killers only if you feel severe pain.

- Drink food that a rich in Fiber

- After few days, try to go the bathroom at the same time everyday and try to keep that routine.... You will be able to keep regular bowel movement.

- For the discharge, you can wear pads or 4x4 (non sterile gauze) that you place between your butt cheek. (I had to change mine many times per day).

- Don't worry, discharge is normal for the first few weeks. It can be yellowish to brownish color and it can have some smell and especially if the seton is other material than Rubber.


My Experience:

- Small bump near the anal area (No pain).
- Bump was sometimes becoming bigger and then start leaking liquid (not smelly).
- Doctor said it is an Anal Fistula and the solution is a Fistulotomy
- I went for the surgery in the morning and it took about 30 minutes.
- They offered me to do it under general anasthesia or with Spinal anesthesia. I chose the second option with a feel good cocktail of medication during the surgery.
- The doctor came to see me after the surgery and told me that the fistulotomy went well but that he also had to place a Seton.

A new episode in my life was starting...

Day 1 to Day 5 after the surgery:
Pain, lot of discharge, not feeling good at all.
Need to accept the situation, the seton, the discharge, etc.
I drove my car after 24 hours and I tried to go for a few minutes walk everyday. Drinking a lot of water and trying to eat healthy.

Week 2 after surgery:
Feeling much better than first week, still some pain and discharge.
Still drinking alot of water and trying to eat healthy

Week 3 after fistulotomy:
Feeling better than week 2, less/light pain and still some discharge.
I Went to the doctor for a follow up and he tightened the Seton (Pain!). The rest wound was healing well and I still have to do sitz bath or clean with shower head 2 times a day.

Week 4 after fistulotomy:
Feeling pretty normal and I feel that the worst part is now behind.

Week 5:
The seton was tightened again (The pain may last for up to 24 hours after the Seton is tightened by the doctor).

The doctor told me that we need to keep a cutting seton usually up to 8 weeks after the surgery and until it falls by itself. If it doesn't fall by itself, the doctor will simply remove it in his office.

My seton felt on week 7 during bowl and few days after I had no more discharge.
I was so happy and that is the point were I totally starting to feel Free again! :)

I saw my doctor few days ago and he said that everything is OKAY but the wound can take up to 1 year to completely heal into a nice scar. I still have to see him again in 2-3 months for a simple follow up.

Good luck to All and remember to stay positive.
There are so many beautiful things we can learn and see when we face difficult times.

On the first 2 weeks after the Fistulotomy, you may find it hard to believe that you will be feeling 100% normal again, but YES YOU WILL! :)

Take care,
D

Jpk_usa
New Member


Date Joined Jun 2015
Total Posts : 1
   Posted 6/8/2015 9:54 AM (GMT -7)   
Been going through info here over the last one year. .. thought will contribute my experience to. .

I had seton/rubber band cutting surgery under general anesthesia in december of 2014. The seton was tightened every 2 weeks 3 times and it fell off in about 8 weeks. Ofcourse the first three weeks the pain was a boon to realize each and every bit around the anus/rectum - a body part I always looked down on :) but as days passed by pain went better.

My goal was to handle my pain with as much less pain killers as possible. ... pain killer help reduce the pain but also cause constipation with make it hard for bowel movements that cause more pain the next morning.

Took 2 to 3 hydrocodine and 3 400mg ibu for first2 weeks each day ~.about 3-4 weeks i was able to stop taking ibuprofen also as the pain was managable.

I started work on 9th day after surgery.. don't ask about productivity. .. as it was Christmas weekend I was able to get buy. (I sit in a chair and work on a computer...... the pain is more manageable when the brain/mind is busy and when there is no one to whom you can complain about your pain)


As of now(June 2015) i am still healing and have some bleeding and puss.. yes still use toilet tissue paper between the cheeks...i can feel with my finger on the anus the cut/lump/granulation (what ever the medical term is for the cut from seton). I take a selfie video of the area with my smart phone to feel the progress. Yes. . Nasty idea but makes me feel better.

Doctor asked me to do anything as i do before the fistula. I am a little cautious. . So I am doing bit of bike riding and running/walking ...a mile or two with my little one. . Since may month.

I have my next appointment this Wednesday and I am to see if the doc gets concerned with pus/bleeding that still coming. He expected it to heal by end of April completely and he seemed a little concerned during my visit in May. Hope i don't have to go to the surgery room again.

Thanks.
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