Exploratory surgery...anal fistula setons...getting really nervous...please share info on setons..

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Regular Member

Date Joined Jul 2009
Total Posts : 342
   Posted 8/6/2009 9:24 PM (GMT -7)   
This is sort of a contin..on my last thread..but the 13th of August I go in for exploratory surgery and of course their is prep..an enema..not looking forward to that....exactly how long does it take for an enema to go into effect and what if i do it wrong...but the surgeon..says he doesn't know what he might find and i might come out with a seton..and i am feeling pretty nervous..like how large is this thing..how uncomfortable..how in the world does a person go to the bathroom? I don't get the opportunity to speak with the surgeon prior to the day..though he kind of explained this stuff to me...i am so nervous....i mean i am wondering what are my options..how much pain will i have the day after..discomfort..i know i have one fistula going through the sphincter..but i feel a tiny one looping around..is it possible that he can get rid of it all at once? Will i be able to wipe myself after? Once I had some kind of packing in me..but that was in like a month..is is the same type of feeling? I only had a drain once with my first abscess and that was only in overnight and it was pretty large...so please though with setons..please tell me your experience..i am so nervous and scared..thanks
also how do i do this enema thing and not screw it up?

Sore Tum
Regular Member

Date Joined Jun 2009
Total Posts : 144
   Posted 8/7/2009 4:57 AM (GMT -7)   
With the enema, you squirt it up your bottom, there's quite alot of it, hold on to it as long as you can (best to lay on your left side with a towel under you), deep breathing, it will feel like you are about to have the worst bout of diarrhoea ever, make sure your near the loo and when you can hold no no longer (I managed 4 minutes) brace yourself, it's like and explosion! It's not pleasent but it is quick and effective.

I had a seton placed 3 weeks ago (only there for a week as it fell out), the day of surgery was fine, lots of lovely local anaesthetic. The next few days were very painful, they give you painkillers for a reason, make sure you use them!

It's quite a small thing like a very small thin elastic band.

I had alot of bleeding from wound when going to the toilet for the first 5-7 days, it was extruciatingly painful, I would jump in the shower and use the showerhead to wash the area as soon as I was done, the spasming would continue for a while after, I was in tears a number of times, but I was also not as strict with the painkillers as I should have been so that was partially my fault. Make sure you don't get constipated.

As I said my seton fell out after a week, so I don't know how this would have affected things long term, I now have a big hole to contend with which is a challenge to keep clean, I always have wet wipes in my bag at the moment and if I'm at home I still get straight in the shower in an attempt to keep it all clean.

I think most of the lovely folk on here that have them do not find them to be too much of a problem, but I'll let them share...I know FallColours has had numerous.

Good luck, they may do it all at once, but at least then you know you're all done. xx
30 year old, female.
Finally diagnosed with severe ulcerative proctitis, Mar 2009. (Doc unsure if it's Crohn's).
?2 fistulas, seton fistulotomy july 2009, 2nd fistula ?currently dormant.
Currently taking, 1200mg asacol TDS, 1g Pentasa supp at night, Probiotics, zinc supplements, Cod liver oil.
Past meds: prednisolone, colifoam ememas.

Veteran Member

Date Joined May 2007
Total Posts : 1220
   Posted 8/7/2009 5:03 AM (GMT -7)   
Hello Frogeleita,

Please don't worry so much! Setons really are not bad at all. I have two and don't even feel them. They are thin plastic threads. It will look like a twist tie you use on trash bags. You won't feel them when you use the bathroom. Check out previous threads for how to live with setons. We have had lots of good discussions. When I am home, I get in the shower and spray everything clean with a hand-held shower sprayer. I also use flushable alcohol-free wet wipes and a small sprayer bottle. Be sure to get plenty of soft guaze to wrap around the setons. The guaze cushions the setons so they won't rub when you walk. I use 4"x4" squares. I don't even feel the guaze anymore. Also, get panty liners or pads to catch any drainage. Use baby diaper rash ointment with zinc oxide if your skin gets irritated by any drainage.

The excellent thing about setons is that they allow pus to drain out instead of abcessing. I started to feel better almost immediately. You may have a couple of days of discomfort after the procedure depending on how much "searching" the surgeon had to do, but usually it is not bad at all. Placing a seton doesn't involve cutting anything so it really is easy.

Enemas make you go and can act fairly quickly, often within 30 minutes to an hour. They are used to empty out the lower colon and rectum. But you said you already have a fistula through the sphincter. I do too and can't use the liquid emenas you squirt into the rectum because the liquid drains out the fistula! And it really burns!!! Ouch!!!! If he gave you a liquid enema, I would call your doctor and remind him you have a fistula and the liquid will drain out. He might prescribe pills instead.

Take care and let us know how it goes!
Diagnosed with Crohn's in early 2007.  Several peri-rectal abscesses and two fistulae with setons.  Allergic to Remicade and Humira.  Currently on 6MP, and vitamins D and B-12.

Veteran Member

Date Joined Jan 2006
Total Posts : 3143
   Posted 8/7/2009 7:04 AM (GMT -7)   
I actually loved my seton. My tushy was sore for a couple days after the process, but the seton fixed my fistula without having a surgical intervention. It was in for a few month and was not sore after the first weeks (I had little to no muscle involvement in my fistula area)
Dx'd '90 (emergency rupture), symptoms ignored long before that, '03 fistulas and bad flagyl reactions, B12 weekly, Pentasa [until I surrender to the bigger meds]
I'm riding on the escalator of life....

New Member

Date Joined Sep 2009
Total Posts : 10
   Posted 9/4/2009 2:09 PM (GMT -7)   
Please if anyone can tell me what were your symptoms of your fistula.

I hear so much about cutting through muscle and ending up with incontenence.
This scares me to death,

Please anyone help?

Elite Member

Date Joined Sep 2005
Total Posts : 10404
   Posted 9/4/2009 3:18 PM (GMT -7)   
Kristi, please click on the abscesses and fistulae link in my sig. That should help give you some answers.
Co-Moderator Crohn's Forum.

Medications for Crohn's ~~ Diet and Nutritional Therapy for Crohn's ~~ Dealing with Abscesses and Fistulae ~~

New Member

Date Joined Sep 2009
Total Posts : 10
   Posted 9/4/2009 9:54 PM (GMT -7)   
Hi, wanted to know if setons stay in forever?

Regular Member

Date Joined Jul 2009
Total Posts : 342
   Posted 9/5/2009 5:40 AM (GMT -7)   
hi to the above poster Kristi 27...some setons..can stay in for a very long time..but not forever...i believe the silk string that i have now..can stay in there for quite a while..in hopes that drying out the tract..that possibly your body will heal and push it out...their are different setons..that you will hear about on this board...some are rubber..some are silk..some are larger than others...some are for cutting through the muscle over a period of time(these are not put in ones body as a first time seton)...i have had two..so i could answer questions if you want to email me..that would be fine..hope this helps..take care

 crohns/colitis/lupus/hyperthyroidism-seton fistula pentasa -Remicade in process


New Member

Date Joined Apr 2012
Total Posts : 1
   Posted 4/16/2012 1:41 PM (GMT -7)   
Is there a more updated thread about SETON and fistulas?

New Member

Date Joined Jun 2012
Total Posts : 1
   Posted 6/25/2012 7:02 AM (GMT -7)   
Hi everybody

Firstly it is lovely to see that I am not alone!! It's so hard because you feel so bad and uncomfortable talking about this stuff.

Well I find a lump on my bottom in may, then surgery 3 days later. They said the fistula caused an abcess. The fistula had been there for a long time and was quite large. They gave me a seton with a thread in it. Healing well but like someone else said going off antibiotics was hard. I mean it just floored me completely and I had to go back on them. Now I just want to know if the following things are normal or common in other people?
1. very itchy internal anus.
2. some times you can really feel the seton and it hurts!!
3. head rushes, dizziness, weakness and feeling like you need to vomit. (this is currently very bad)
4. diaarhea 5 days, then no stools 2 days, then diaarhea. Its like my tummy has no idea what it is doing!!
5. Also I am due back work next week, now everyone is telling me not to go back yet but I would like to know how everyone else coped with going back to normality etc.

Now the good news is my consultant seems a lot smarter than his registrar. The registrar ignored all my complaints above said it was nothing, that he was removing the seton in 6 weeks time and i didnt need any investigation because fistulas are caused by 'hard stools'.

The consultant has said I need a colonoscy straight away due to suspected crohns and that will help him decide what to do next. Which is a relief because it is so hard not knowing what is happening and sitting in limbo. Also be honest does this sound like crohns?

Thanks for reading, I appreciate it!
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