Fistula, and fistulagram questions

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Date Joined Sep 2006
Total Posts : 2527
   Posted 12/11/2007 2:04 PM (GMT -6)   
Hi all,
I am scheduled for a fistulagram tomorrow.  My fistula is enterocutaneous and is right under my belly button.  I have had this fistula since Sept 16th...that is when the skin finally opened up and began to drain I had the pain in the area though for a few months prior.  I find that the fistula drains quite a bit then some days hardly any.  The past couple of days I havent seen little if any stool come out onto the gauze.  There is still blood and pus that comes out though.  they exhausted all other methods trying to close the fistula antibiotics, cipro and flagyl.  They have me on HUmira when I was due for my dose before I noticed I would have increased drainage a few days after the injection the drainage would lessen.  I am now scripted to do 1 injection every week.  They also had me on TPN the doc saw it was almost healing when I saw him in the office, the following week I was admitted back to the hospital with a fever which after tests I had picc line sepsis.
The doc saw that the mucosa was sticking out above my skin making the fistula appear like a mini stoma.  Then when I saw him back at the office a week after I was discharged the mucosa was back inside my belly and the fistula is flush with the skin again.  He said that was the first time he had ever seen the mucosa go back in.  I told him that wasnt the first time it had done that.  I am only on my 2nd month of the humira weekly but the past few days hardly anything is coming from the fistula.  Last night when cleaning it...I literally place a qtip into the fistula and clean it out in addition to the skin around it.  Before when I had a localized abscess there from a suture the doc had me placing gauze into the hole with a qtip and when I go to him he does stick the q tip in to determine the depth etc.  My skin keeps getting yeast infections so not only am on Diflucan 200mg I also have to put the miconozole powder (the athlete's foot powder is cheaper than my co pay on the script for the same % of active ingredient) then spray no sting skin prep over the area with powder.  I have to place a qtip in the hole at that point to avoid getting the powder and skin prep into the fistula sicne it would cake up.
After placeing the qtip in it many times I will bleed but clots come out too not just plain blood.  Last night when I cleaned the area for my bandage change there looked to be no drainage what so ever on the gauze just the calmaseptic cream transferred to the gauze that I place on my skin since it is a protectant and it even lists fistulas as a use for that cream.  I used my q tip to clean out my belly button since a lot of discharge gets in there since they are so close to each other.  Then I did the qtip in the fistula then all of a sudden a bunch of brownish pus came out.  I have always had a combo of blood, pus and feces come out of the fistula.  I still have gas come out of the fistula but no feces unles that is what caused the pus to be a yellowish brown color.  This moring the bandage just appeared to have blood and pus.  the outer area of it was brown in color but I am unsure if that was pus and blood mixed together.  it was not dry yet it was brown I was able to move it around with a q tip but used some wet gauze to clean it off.  Before the feces coming out was so bad some days I had to scrape patties of poop off of my skin as well as really pad the bandage up so it would not leak.
I have a fistulagram set up for tomorrow and I was told that there is no prep for this procedure.  I have never had this test before so I am a little nervous since I am not given anything.  I know they will insert a scope into the fistula which should not bother me being that I use qtips in it to clean it and there is no feeling.  I also have a colonoscopy set up for the 20th.  these are all in preporation for surgery to remove the area of diseased intestine and remove the fistula.  I just wonder if it is starting to heal or if it is doing its thing where it slows down drainage then soon pick up like crazy again.
Anyone have any thoughts as far as what this darn thing is doing since my doc is even baffled I dotn know what to think?
Has anyone had a fistulagram before?  Did you have any type of prep for it?
Thanks for any responses
Dx with Crohn's 1987, symptoms as early as 1984.
Temp iliostomy February 2007, reversed June 2007, Ovarian cysts, migraines, allergies (incl food allergies) , oral allergy syndrome (diff than true food allergies), Asthma, Gall Bladder removed 1999, Inguenal hernia 1987

Veteran Member

Date Joined Apr 2006
Total Posts : 733
   Posted 12/11/2007 2:08 PM (GMT -6)   
I don't know, but I am so sorry you are going through that.
Diagnosed with Left-sided Ulcerative Colitis 1995 at 15
Tried: Prednisone, Rowasa & Hydrocortisone Enemas, Proctofoam, Sulfasalazine, Asacol, Probiotics, Fish Oil, Canasa, Enotcourt, Colazol, Proctocort, Anamantle...
Diagnosed with Ulcerative Proctitis with rectal fistula in 2004, put on Remicade
2007:Increased Remicade dosage-660mg every 6 weeks,diagnosed with Psoriatic Arthritis & Fibromyalgia
Current meds: Remicade 660mgs every 6 wks, Lomotil, Tramadol, Darvocet, Clorazepate, new meds I am about to start: Prograf, Cymbalta, Lyrica

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