Just had my surgery yesterday. I was happy to find out it was superficial and surgeon was able to fistulotomy. At pre surgery consultation after MRI, he told me he anticipated me needing two surgeries, 4-6 weeks apart. Hopefully healing goes well and I'm good in a few weeks.
@@metaphorsk I'm now 4 months post-op. Overall, I'm doing well. Don't really have any pain, and if I do, it's mostly mental. I didn't have to do any dressing/packing or anything like that after surgery. Brief timetable of everything: Sept 21 - Fistulotomy Next 7-10 days, low fiber, low residue, largely liquid diet, and about 3 sitz baths per day. Took about 36-48 hours post surgery for first BM. Not pleasant, but not as bad as I feared. After about 3 weeks, the daily blood and pus drainage had subsided about 95%. Oct 18 - Four week follow-up with surgeon. He said to count on another 4-8 weeks healing time. The wound was still open, still slightly swollen, still draining slightly. Mid November - Around the 8 week mark post surgery, I thought I was out of woods, as my butt sweat post workouts had a normal pattern for the first time. Then the morning after Thanksgiving, after not wearing pad or anything overnight, had significant drainage overnight, but not blood, pus, or feces. Liquid. Either water, sweat, or clear mucus. Dec 12 - Twelve week follow-up, I expressed concern about my drainage/leakage overnight. CRS declared me fully healed and said I had a sweaty butt. The drainage I am/was experiencing overnight is not that of normal butt sweat, though. Fortunately, I was able to find some forums on Reddit and Quora, and people who dealt with the drainage for up to 9 ,months to a year post surgery. I will say, 2 of the past 3 days, I've had less drainage. I am documenting any overnight drainage with pictures of my underwear, and was told by PCP about a week after CRS 12 week follow-up, that if I was still dealing with that at the 6 month mark to either call CRS and demand to be seen, or call PCP for referral to different CRS. Unfortunately, it's just a long process and you have to be patient. My diet is about 95% back to where it was pre-surgery. I still try to be careful and not overindulge, or eat anything too greasy or spicy. I'm really hoping the trend I've noticed over past few days continues, and if it does, maybe I'll be out of the woods by this time next month. I'd be happy with that.
Hopefully you all healed up. Please any updates since? Was the MrI necessary for the doctor to determine what kind of issues it was and how was recovery?
I've had my fistula for 18 years. I did go to a couple of colon surgeons early on to get a consultation. It flares up occasionally. It was actually completely flat and healed so much so that I couldn't feel the fistula for a year. Unfortunately, it came back a week ago. I've been able to live a normal life, which is why I chose to not have surgery. I will see a colon doctor soon just to have it looked at but don't have any plans on having the surgery.
VERY HELPFUL! I just had a fistulotomy a week ago on April 25, 2023. So far, so good. I was discharged without speaking to the doc and had a hard time finding out exactly what he found and did. I will have a follow up appt on May 18 in person. I finally spoke with him today and still did not learn much. I asked how far he went inside. He said, "millimeters". I didn't follow up with "how many millimeters", which was silly on my part. He also said, there was nothing out of the ordinary, just standard, straight forward, nothing abnormal, no cancer. I wish he had been a bit more specific. I will have a detailed list of questions when I seen him in a few weeks. Any suggestions on questions I should ask? Thanks so much for your channel! So helpful! THANK YOU! PS - I've been taking pics every day to see the progress of healing. Just wanted to document incase anything weird develops...
How painful was the recovery? I’ve just recently been diagnosed with an anal fistula, however I’m still waiting to see my GI to find out how bad it might be because I have active Crohn’s disease but only really having issues in my rectum right now. Less than two weeks ago I started to get this agonizing pain in my rectum which I thought was due to my thrombosed haemorrhoids but because I’ve had those before I knew there was something else wrong. In less than 7 days it got so bad that I couldn’t get out of bed, couldn’t walk, sit down, go to the washroom or even sleep without agonizing pain which is why I eventually ended up in the ER. That is where they discovered a perianal abscess near my rectum in a CT and decided to drain it right there and than and OH MY GOD, I have never felt so my h pain in my entire life and I’ve had Crohn’s for over 15 years, also severe complications with my spine! However, this was by far the worst pain I have ever experienced which makes me think something went wrong when they cut into my abscess. To be honest, I just had a full colposcope and endoscopy a few months ago and didn’t detect a fistula whatsoever, so unless these things can form quickly I think the ER doctor in fact cut too deep and did this to me! So angry! Anyhow, now I have an open wound that won’t stop oozing puss (it also tested positive for e.coli infection) for 6 days now and going to the washroom is torture. So now I’m looking at my options to try to heal this or have it repaired but have heard so many say that things like fistula and hemmorroid repairs can be so bloody painful. I was just coming out a 6 month flare and finally starting to feel good when this happened, so while I can handle an extreme amount of pain I feel like I’m on the verge of giving up because this pain is just so unbearable. So I’m just wondering what the recovery for something like this would feel like. I’m also a natural health advocate and for the longest time was dealing with all my health issues naturally with some great success so this all comes as a shock to me and to think it all started due to an extreme amount of stress O endured a few years ago after both my father and mother-in-law were killed by the medical establishment during CV. So on top of everything else, I also have white coat Syndrom and don’t trust many medical professionals anymore especially after watching how they handled the last 4 years.
@@Novelbrocolli Hi There, unfortunately I still have not had anyone do anything about my fistula. I live in Canada so finding good help here in terms of our medical system can be pretty difficult especially with what is currently happening in our country. However, I am going to see a surgeon today to see what my options are for having this repaired. I did see one a while back (about 3-4 months ago) but all she could offer me was a Seton drain and told me that she would do nothing else for me because of the Crohn's. My GI insists that I need to be on a dangerous Biologic drug that he say's could potentially close the fistula after he Seton surgery but in taking this drug I risk a whole list of other potentially dangerous side effects one of which would be cancer and a lowered immune system! So I'm a little hesitant to take that route espeically because I have never taken any drugs in my life not even over the counter stuff form the pharmacy for anything really. On the flip side, my fistula is no longer really painful thank goodness because I have been doing a ton of natural modalities and making my own suppositories to try t o heal it and to insure it does not abscess again so while it is still a neuseance to care for every day, at least it isn't painful anymore and appears to be somewhat healing.
Great explanation. I had this surgery. I had an anal fissure. I saw a CRS twice who hurt me a lot ( I screamed) with instruments during two exams, said I needed surgery, and scared me away. It seemed to mostly heal then the pain and bleeding seemed to move outside. My second gentle CRS said I now had a superficial fistula, a tunnel but I was still scared. I finally had surgery in July 2022. I got lucky. It took 2 days for the pain after a BM to be less than before the surgery! Why did I put it off?
Very helpful Doc and please know that you are making huge impact. Would you please make video on 1. Seton 2. Diet during the seton 3. Non superficial fistula. 4. How to manage post op care. Thank you.
Hi doc. Your reply would greatly be appreciated. What would you advise for a non healing fistulectomy after 4 months? Another surgery or watchful waiting ( as recommended by another surgeon)? Thanks
My sister died in May 2023 with Colo vaginal fistula. It slowly damaged andshut down all of her organs because she was not healthy enough to go thru the surgery. It effects all of your organs and we thought she had died from sepsis. She died suddenly from a enlarged heart. It all started from fistula and it effected all of her organs shutting down one by one. Eventually hitting her heart. I truly believe.
My hubs fistula leaked a horrid orange fluid on and off for yrs. No one wanted to touch it because the mother of the subway system of leakage was too close to his scfincter muscle,one slip and he'd need a colostomy bag...he had to use sanitary pads under his suit....until,we met Dr Joseph Gallagher of Orlando,Florida. " I'll do it" he said and he did.our hero! Love u doc, still. There was a big hole which I had to clean with a water pik so it healed from the inside out.. his was so bad.poor guy.antibiotics would clear it,then,of course it's back. His sweat glands on both sides of his " crack" actually opened. Hell. Problem never returned.
Thank you. I am going into surgery next week for one. I have been a bit scared and thinking about it. But after watching a few of your videos I feel a bit better to talk it over with the surgeon to see about options.
@@TechyAviral I had the OP and it was laid open. It was quite painful but not as much as others have said. I felt ok after 2 weeks and went a 2 hour walk and bleed out so having to take it easy. other than that, it seem to be healing quite well and the usual pain and irritation I have had from it is not there anymore - fingers crossed 🤞🏼
@@davidc2837 it feels like it’s gone back to when i first started to feel it. there is not that much pain if any at all - then I feel a niggle. So it’s still there but no where near the pain and discomfort as before. It’s More just an awareness of it now.I have an appointment with the surgeon coming up so I will let you know more then. I would be happy if it stayed this way. Fingers crossed:)
Hi Dr, I wish I was still living in CT as I'd come and see you. About 3 weeks ago, I developed my first ever abscess. It naturally drained, and I took a 10 day course of antibiotics. It seemed to have cleared. Now today, after wiping there was a some blood and on my underwear there was some drainage. There's no pain thankfully. Is this normal, or should I be worried? I don't want a fistula. 😨
Good Day Dr. CHUNG., MY BROTHER got his operation for perennial abscess a month ago, now, the wound is still there, and surprisingly, a blood came out from the inside of the wound, and the opening which was left open after the operation as what the doctor says that it needs to open for the possibilty of the puss still coming out from inside, is now getting wide a little hence it burst again with blood coming out from it. He the go back to his doctor and his doctor referred him to another doctor and telling him that maybe there is a possibility that he got fistula. We are so wooried Dr. CHUNG, but my brothers medical laboratories are all in normal result. His blood sugar, is normal, and even his biopsy is negative of a cancer cells.. What shall we do now Dr., We will just observe and pray for the healing of our dear brother.. Thank you doctor
@@gigia3401 I had mine yesterday. Keep the stool soft postop would be my #1 advice. Eating lots of papaya, both green & ripe along with miralax, metamucil & 3 dulcalax stool softner. Stay away from laxatives though. The pain is less than Sphincterectomy. But still in pain. But again I m only on my 2nd day.
You were able to explain it lightly. It lessens my worries. Maybe it is better to see actual surgery? And can you tell us the healing process? What kind of anesthesia need to be used. Thanks
In Germany, they used general anesthesia for my surgery. It was not just a fistulotomy, they cut out the fissure that caused the fistula. First week was a little painfull, but really managable. First poop was scary. I had to use the shower head to clean the wound 4-5 times a day (and after every poop) for 4-5 minutes. Than put a dressing with ointment on the wound. After about 3 weeks, the cleanings can be done less often, about 3 times a day. It's healed more or less so you can do everything like easy sports after 4-6 weeks, and the wound is completely healed after about 3 month. But it was a resection of a fissure, as I said. The Dr. said, there are more chances it heals completely if they remove the cause.
Hi Doc, your videos are very informative. I have gone through an abscess drain surgery for ischiorectal abscess and during the surgery my doc located fistula and installed seton. My healing is going really well and I saw my doc yday and he was very happy with the progress. Q I have, my doc said I may have superficial or intersphincteric or transsphincteric fistula depending on how it heals, would he not know the kind already based on how he installed the seton already? I’m in complete trust with my doc but just trying to understand about the ambiguity around the fistula type. Thank you in advance!
Really starting to believe I may have an anal fistula …. it’s seriously so frustrating and depressing having to deal with abscesses that recur literally almost several at one time over and over again .. the cycle is so traumatizing and agonizing I just lose hope in seeing an end to this 😣
@@559talk9 mostly recurring abscesses showing up every 1-2 weeks near my inner thighs, groin, an anus area. Tend to resolve on their own but mostly been using warm wet compresses to draw out the inflammation .. they usually vary in size and form generally in the same locations over and over again. I can tell when I’m getting one bc the area becomes slightly painful, a small bump appears and is painful to the touch also usually red.
@@graphicsguy2023 thank you. Do you have discharge? It’s pretty crazy but I have no pain or issues with bell movement I just notice after I pass stool a few hours later it’s damp on that area and kinda brownish discharge appears. No pain or blood. Not sure what it is
Is fistula below the dentate line all considered as superficial? I had a fistulotomy two years ago; it took me alsmot half a year to have completely no pus from wound healing. Dr 'flipped' open my wound for first month to ensure the open grove heals bottoms up like a V shaped welding layers. Since then I've been feeling the scar tissue has become easily irritable like a fissure, with feeling of itch, slight pain, swell etc every now and then. Is that possible?
dr chung i had skin tags ,removed them thinking my itchy and bleeding but the tags still came out and the itch still there i can feel a small pimple under the lower skin tag and is there where it itch, i,m using antifungal,antibiotic cream and is a bit better but the doctors when they visit me they say they don,t see or feel nothing it,s only me when i touch i feel a small pimple,can it be a fistula
Thank you for this video. How long would it take to recover from superficial fistula? My husband had surgery about 2months ago and still continues with some discharge and due to that moisture develops some sort of rash and redness on the inside of butt cheeks. Any advice would really help. His surgeon continues to tell him to give it time but it just seems too much .. he is constantly in pain and discomfort.
My surgeon said it should b mostly healed by 2-3 weeks. 2 months sounds awfully long. Change your colorectal surgeon & see possibly two additional different surgeons to cross check what they suggest. Good luck!
I like the picture in picture - feels interactive. I see you are really improving the quality of your videos. Would the picture drawing work with an ipad/stylus instead, so you could be more carefree when drawing? I appreciate your constant improvements
Hi dr Chung I just wanted you tell me the symptoms of a fistula because I have painful defecation and throbbing after pain I do suffer from piles but this pain is different I have throbbing pain for hours after passing stool I am going for a sidmiostocopy on the 9th will a fistula or fissure show on this test. Could you let me know please no am desperate thankyou
I am diagnosed with anal fistula before one week, the surgeon after saw the mri said it hasn't touched the muscles so is superficial. They want 1600 euro to make the surgery, money which i don't have yet because i am a student and i don't have anyone to help me. My question is: What will happen with my fistula if i leave it for some time till i have the possibility to pay for it?, will it change directions or touch muscles?, or grow bigger? Thank you
Hi Dr. Chung, I was recently misdiagnosed with having an Anal Fissure and after going for a second opinion was told I have a Superficial Anal Fistula.😮 So much PAIN & Drainage caused me to get the second opinion after being told the drainage was normal for an Anal Fissure I knew I wanted another opinion. The first Doctor told me I needed a follow up visit for him to inject Botox into it. Of course I didn’t have that done and I’m currently scheduled for the surgery 3/27/23 you mentioned in this AWESOME video. How long will it take for me to return to work? Thank you for this video!
You surely know now how long it took, but for others: I think, the pain level is different for everyone and every surgery is different. And it depends on your job. If it's a job that can be done from home lying in bed with your laptop, you can start sooner. If it's a job where you are physically active, it takes longer to be able to work the whole day.
Hello, several months later "I'm doing incredible!" The surgery was very successful and the recovery wasn't without some challenges! However, I did quite a few follow-up visits to my Doctor. I did experience so interesting things, which I found out was "normal" to the healing process. because I DID NOT want anything to grow back and the least little itch, slight pain or slight blood I made an appoint to be reexamined lol! So Far SO GOOD weeeeeesh! @@amritnalam9994
Great Point! So Grateful to be on the other side of this situation! Never that something so "small" can shift your life! "I cld write a book"!@@lenakohl2339
Good morning I have four anal fissure (4) procedures go in on my fifth (5) one . Is there a reason why I keep on getting anal fissures ? Also is there other treatment other than surgery ? At this time I am using C -Nifedipine 0.4% for a week now as prescribed by my doctor . Would you recommend some other treatments ? Thanks Andy D
Your story is a bit more complicated since you had several procedures for your fissures. I would need more information to give a helpful response. Check the description box for video consult details if you are interested. I wish you the best.
What type of procedures did you have!! LIS is typically the gold standard for fissure & once should be enough or at most twice. 5th sounds awfully too many procedures.
Excellent information I just had an anal fistula (superficial) surgery and now I am taking rest after surgery and getting better, and I feel more energy and better vibes after this video. thank you I am so much happy, due to my sphincter muscles is not involved and the recurrence rate is below 5%. From Nepal
Two and 1/2 years ago I was diagnosed with a fistula and the doctor recommended that I take Phillips milk of magnesia. and without milk I can't take a bath and that worries me, what can I do? aid
Any insight as to the signs it may be superficial vs going through the muscle that I may consider? Very anxious with fistula diagnosis, but need to wait for colonoscopy for surgeon to get the first look at it. Your videos have helped me understand what has been going on since the abscess.
I’m 1 week in after my surgery, I can tell I’m in the inflamed stage of the healing cause it’s itching like crazy. Hopefully it stops by next week or so.
@@davidc2837 I’m actually glad you asked. I have a new one that showed its head but the first surgery wound has healed some. Definitely feels like melted flesh 😂
Great information! I believe I am having this at the moment, although I went to see a doctor and she said it was just an abscess and currently just prescribed me with antibiotics and lidocaine gel. But, somehow I thought maybe this was it because there was a palpable small mass from the small opening on the outside towards the anus
Thank you for all the information, i sure wish the proctologist that is doing my surgery in a week was more like you! My question is, if you were to perform a fistulatomy would you not want an MRI to see everything BEFORE you laid open the fistula? My surgeon told me thst she usually does not do MRI's ( i found this very odd) is this irregular? She scoped the rectum with a camera and she said it was a superficial fistula.. does that make her not need an MRI? I am very nervous i almost had to twist her arm to get the mri done and somewhar fearful if i havw the correct dr operating on me. She also found a chronic fissure and recommended botox injection, will the expected incontinence go away fully? Will there be need for repeated injections ? Will there be any permanent change in the rectum? I know i asked quite a few things but if you could help me with any of them it would reallt ease my mind.
These are all good questions. It seems to me you need to continue the discussion with your surgeon. You may also consider a video consultation with me as well. Wish you the best.
@@kinnubuttardhillon7899 my doctor told me by insert his finger in anal, and verified that I have superficial anal fistula. I didn't see any from out side??
what about after an abscess does that come from.the old wound site. my wound was never flat after now they suspect fistula. it's now drained through old abscess wound by becoming a tiny hole.
December Log: Campylobacter/food poisoning led to tooth ache, to constipation, to anal fissure so painful dentist refused to extract tooth when I sat in her chair. Now have watched more "Friendly Proctologist" reruns than all Jackie Gleason "Honeymooners" episodes ever syndicated. Wife refuses to listen of me explain finer points of differences of insoluble vs soluble fiber & importance of taking Miralax instead of Metamucil...
Hello doctor, I am a desperate, scared mother, 😭😭😭I have a problem with my little girl, I went to the doctor and he told me that she has a pilonidal cyst and a perianal fistula, I don't want the classic operation, I saw that minimally invasive methods without cutting, please help how can we proceed? what to do?help my daughter please😭😭😭 Thank You 🙏 🙏🙏
Thank you for this wonderful video Dr.Chung ! I have a question . So since the surgery is done really close to the anus , will it be really hard to poop after the surgery ? And what needs to be done ?
I was prescirbed pain killers and made sure to keep the stool soft. The first time was scary and took some time, but after a couple of days it was better than the discomfort I had before surgery.
What about taking no action regarding it? I have been diagnosed with a superficial anal fistula while waiting for my anal abscess wound to heal for around one month.
Went poop yesterday. Dehydrated it was painful. Today i wake up with a pea sized knot on my bottem hole. Its been very painful, as im watching adjusting in my chair, the pain is suddenly gone. The pea knot is going away. Weird. Do i see a dr? Idk
Dr. Chung, this is very informative and helpful. I have a question tho. I have this pimple very near the anus opening. It keeps on coming back, I have checked our local doctor and gave me antibiotics twice, but is still recurring. There is mininmal to no pain at all and it bursts on its own. There are days/ weeks that the wound would close but there are days where a pimple keeps coming back on the same spot. Is this fistula already?
I had a pimple next to wear i poop. It didnt hurt when i pooped but it did feel wierd when ill walk. It hurted for a couple days and i started putting alcohol on a paper towel every time i came out the shower. It went down and andd no pain no nothing .. like 3 days after i started feeling like weird on like the top of my butt crack like bumbles inside my anal is not hurting but like the inside of my lower back is started to feel like some irritation.... Tomorrows my day off im going to the clinic to see a doctor in so scared i seen pictures of surgery omg 😭.... Can u help with anything ill REALLY REALLY APPRECIATE IT !
My abcess had to be drained and my primary care physician put the hole far away from the anus sadly. I just had a cutting seton installed by my CRS today and i cant help but feel like my PCP screwed up and made the tunnel bigger and more likely to go through muscle
Hey doc, so I recently had a colonoscopy. He noted I do have a fistula but it hasn’t bothered me since it happened. And the external opening isn’t far from my actual anus. He recommended I get it fixed eventually. But wanted to ask your input.
Compliments Doctor, I greatly enjoy your channel. I have been diagnosed of anal fissure that has lasted for some time, my doctor has sent me for a colonoscopy and am so scared of having it, because the anal area is still inflamed
Had my first diagnosis back in 2007 and had my first fistulotomy. I can’t thank enough to my doctor….my quality of life been better after.
Hey! How painful was it ?
I had my surgery done at Kaiser Fremont California for about 3 yrs now. So far so good no more pain. Thank you Doctor Follestad
Hi , how can i contact you 🥺 I've got questions
😮
How can I contact you. Have some questions. Dr follastad is my doctor as well. I have fistula , is considered to have surgery. Thanks!
@@paulalee9884 I put my email address couple of times for some reason it don’t show.
@@manongsfoodreview5141 did have simple or complex fistula. How long was the recovery. Any tips to share? Thx!
Just had my surgery yesterday. I was happy to find out it was superficial and surgeon was able to fistulotomy. At pre surgery consultation after MRI, he told me he anticipated me needing two surgeries, 4-6 weeks apart. Hopefully healing goes well and I'm good in a few weeks.
How are you now? Does it hurt? Dressing/packing wound etc?
@@metaphorsk I'm now 4 months post-op. Overall, I'm doing well. Don't really have any pain, and if I do, it's mostly mental. I didn't have to do any dressing/packing or anything like that after surgery. Brief timetable of everything:
Sept 21 - Fistulotomy
Next 7-10 days, low fiber, low residue, largely liquid diet, and about 3 sitz baths per day. Took about 36-48 hours post surgery for first BM. Not pleasant, but not as bad as I feared.
After about 3 weeks, the daily blood and pus drainage had subsided about 95%.
Oct 18 - Four week follow-up with surgeon. He said to count on another 4-8 weeks healing time. The wound was still open, still slightly swollen, still draining slightly.
Mid November - Around the 8 week mark post surgery, I thought I was out of woods, as my butt sweat post workouts had a normal pattern for the first time. Then the morning after Thanksgiving, after not wearing pad or anything overnight, had significant drainage overnight, but not blood, pus, or feces. Liquid. Either water, sweat, or clear mucus.
Dec 12 - Twelve week follow-up, I expressed concern about my drainage/leakage overnight. CRS declared me fully healed and said I had a sweaty butt.
The drainage I am/was experiencing overnight is not that of normal butt sweat, though. Fortunately, I was able to find some forums on Reddit and Quora, and people who dealt with the drainage for up to 9 ,months to a year post surgery. I will say, 2 of the past 3 days, I've had less drainage. I am documenting any overnight drainage with pictures of my underwear, and was told by PCP about a week after CRS 12 week follow-up, that if I was still dealing with that at the 6 month mark to either call CRS and demand to be seen, or call PCP for referral to different CRS.
Unfortunately, it's just a long process and you have to be patient. My diet is about 95% back to where it was pre-surgery. I still try to be careful and not overindulge, or eat anything too greasy or spicy. I'm really hoping the trend I've noticed over past few days continues, and if it does, maybe I'll be out of the woods by this time next month. I'd be happy with that.
Hopefully you all healed up. Please any updates since? Was the MrI necessary for the doctor to determine what kind of issues it was and how was recovery?
Dr. Chung, I could listen to your voice all day!!
Thank you so much for the information, you’re great.
I've had my fistula for 18 years. I did go to a couple of colon surgeons early on to get a consultation. It flares up occasionally. It was actually completely flat and healed so much so that I couldn't feel the fistula for a year. Unfortunately, it came back a week ago. I've been able to live a normal life, which is why I chose to not have surgery. I will see a colon doctor soon just to have it looked at but don't have any plans on having the surgery.
18 years ?
im going on 1 year. same as you describe.
I have mine for 24yrs seen Dr yesterday
I have had for 1 week and it hurts
How does anal fistula looks like? Can we see it from outside?
4:52 does drainage require anesthesia? Sometimes it's similar to swelling after root canal procedure in dentistry.
Best concise discourse on this condition. No BS.
VERY HELPFUL! I just had a fistulotomy a week ago on April 25, 2023. So far, so good. I was discharged without speaking to the doc and had a hard time finding out exactly what he found and did. I will have a follow up appt on May 18 in person.
I finally spoke with him today and still did not learn much. I asked how far he went inside. He said, "millimeters". I didn't follow up with "how many millimeters", which was silly on my part. He also said, there was nothing out of the ordinary, just standard, straight forward, nothing abnormal, no cancer.
I wish he had been a bit more specific. I will have a detailed list of questions when I seen him in a few weeks. Any suggestions on questions I should ask?
Thanks so much for your channel! So helpful! THANK YOU!
PS - I've been taking pics every day to see the progress of healing. Just wanted to document incase anything weird develops...
How painful was the recovery? I’ve just recently been diagnosed with an anal fistula, however I’m still waiting to see my GI to find out how bad it might be because I have active Crohn’s disease but only really having issues in my rectum right now. Less than two weeks ago I started to get this agonizing pain in my rectum which I thought was due to my thrombosed haemorrhoids but because I’ve had those before I knew there was something else wrong. In less than 7 days it got so bad that I couldn’t get out of bed, couldn’t walk, sit down, go to the washroom or even sleep without agonizing pain which is why I eventually ended up in the ER. That is where they discovered a perianal abscess near my rectum in a CT and decided to drain it right there and than and OH MY GOD, I have never felt so my h pain in my entire life and I’ve had Crohn’s for over 15 years, also severe complications with my spine! However, this was by far the worst pain I have ever experienced which makes me think something went wrong when they cut into my abscess. To be honest, I just had a full colposcope and endoscopy a few months ago and didn’t detect a fistula whatsoever, so unless these things can form quickly I think the ER doctor in fact cut too deep and did this to me! So angry! Anyhow, now I have an open wound that won’t stop oozing puss (it also tested positive for e.coli infection) for 6 days now and going to the washroom is torture. So now I’m looking at my options to try to heal this or have it repaired but have heard so many say that things like fistula and hemmorroid repairs can be so bloody painful. I was just coming out a 6 month flare and finally starting to feel good when this happened, so while I can handle an extreme amount of pain I feel like I’m on the verge of giving up because this pain is just so unbearable. So I’m just wondering what the recovery for something like this would feel like. I’m also a natural health advocate and for the longest time was dealing with all my health issues naturally with some great success so this all comes as a shock to me and to think it all started due to an extreme amount of stress O endured a few years ago after both my father and mother-in-law were killed by the medical establishment during CV. So on top of everything else, I also have white coat Syndrom and don’t trust many medical professionals anymore especially after watching how they handled the last 4 years.
@@TheHealingHandsDuohey! Did you get any surgery ?
@@Novelbrocolli Hi There, unfortunately I still have not had anyone do anything about my fistula. I live in Canada so finding good help here in terms of our medical system can be pretty difficult especially with what is currently happening in our country. However, I am going to see a surgeon today to see what my options are for having this repaired. I did see one a while back (about 3-4 months ago) but all she could offer me was a Seton drain and told me that she would do nothing else for me because of the Crohn's. My GI insists that I need to be on a dangerous Biologic drug that he say's could potentially close the fistula after he Seton surgery but in taking this drug I risk a whole list of other potentially dangerous side effects one of which would be cancer and a lowered immune system! So I'm a little hesitant to take that route espeically because I have never taken any drugs in my life not even over the counter stuff form the pharmacy for anything really. On the flip side, my fistula is no longer really painful thank goodness because I have been doing a ton of natural modalities and making my own suppositories to try t o heal it and to insure it does not abscess again so while it is still a neuseance to care for every day, at least it isn't painful anymore and appears to be somewhat healing.
Any updates?
@@alexanderthegreat8067 Who are you asking?
Great explanation. I had this surgery. I had an anal fissure. I saw a CRS twice who hurt me a lot ( I screamed) with instruments during two exams, said I needed surgery, and scared me away. It seemed to mostly heal then the pain and bleeding seemed to move outside. My second gentle CRS said I now had a superficial fistula, a tunnel but I was still scared. I finally had surgery in July 2022. I got lucky. It took 2 days for the pain after a BM to be less than before the surgery! Why did I put it off?
You don’t feel anything now from 2 years after the surgery
How are you now? Fully recovered?
Hey! How bad was the pain post surgery ?
very well explained and such a great teacher too!! Thank you Dr. Chung
Thank Dr. Excellent explanation. The drawing was very helpful 😊
Thank you Dr you are a kind hearted person.you give us such a nice information
Very helpful Doc and please know that you are making huge impact.
Would you please make video on 1. Seton 2. Diet during the seton 3. Non superficial fistula. 4. How to manage post op care. Thank you.
Great question! It has been added to the list.
@@yourfriendlyproctologist doc what do you called if you have two fistula on both side of my butt
This was super helpful! Thank you. Hoping the stars are on my side and this is what I have when I go in for my check up!
The drawing really helped. Understood it right away!
Hi doc. Your reply would greatly be appreciated. What would you advise for a non healing fistulectomy after 4 months? Another surgery or watchful waiting ( as recommended by another surgeon)? Thanks
My sister died in May 2023 with Colo vaginal fistula. It slowly damaged andshut down all of her organs because she was not healthy enough to go thru the surgery. It effects all of your organs and we thought she had died from sepsis. She died suddenly from a enlarged heart. It all started from fistula and it effected all of her organs shutting down one by one.
Eventually hitting her heart. I truly believe.
Did she consultant doctor and took antibiotics. Sorry for your loss. Sad
My hubs fistula leaked a horrid orange fluid on and off for yrs. No one wanted to touch it because the mother of the subway system of leakage was too close to his scfincter muscle,one slip and he'd need a colostomy bag...he had to use sanitary pads under his suit....until,we met Dr Joseph Gallagher of Orlando,Florida. " I'll do it" he said and he did.our hero! Love u doc, still. There was a big hole which I had to clean with a water pik so it healed from the inside out.. his was so bad.poor guy.antibiotics would clear it,then,of course it's back. His sweat glands on both sides of his " crack" actually opened. Hell. Problem never returned.
Is it necessary to drain this beast, or something like amoxicillin can neutralize it?
Thank you ...this is a really straightforward explanation...totally understandable
Tons of thank Doctor for explaining this topic in detailed
Thank you. I am going into surgery next week for one. I have been a bit scared and thinking about it. But after watching a few of your videos I feel a bit better to talk it over with the surgeon to see about options.
So how it's going now?
@@TechyAviral I had the OP and it was laid open. It was quite painful but not as much as others have said. I felt ok after 2 weeks and went a 2 hour walk and bleed out so having to take it easy. other than that, it seem to be healing quite well and the usual pain and irritation I have had from it is not there anymore - fingers crossed 🤞🏼
@@captainvuk1 I hope u do fine is your fistula was deep close the the anal
@@captainvuk1 update?
@@davidc2837 it feels like it’s gone back to when i first started to feel it. there is not that much pain if any at all - then I feel a niggle. So it’s still there but no where near the pain and discomfort as before. It’s
More just an awareness of it now.I have an appointment with the surgeon coming up so I will let you know more then. I would be happy if it stayed this way. Fingers crossed:)
I need to know what if it does go through the tissue and muscle?
Hi Dr, I wish I was still living in CT as I'd come and see you.
About 3 weeks ago, I developed my first ever abscess. It naturally drained, and I took a 10 day course of antibiotics. It seemed to have cleared. Now today, after wiping there was a some blood and on my underwear there was some drainage. There's no pain thankfully. Is this normal, or should I be worried? I don't want a fistula. 😨
Is there a significant difference in fissures/ fistulas with Crohn’s disease to non Crohn’s disease
Good Day Dr. CHUNG., MY BROTHER got his operation for perennial abscess a month ago, now, the wound is still there, and surprisingly, a blood came out from the inside of the wound, and the opening which was left open after the operation as what the doctor says that it needs to open for the possibilty of the puss still coming out from inside, is now getting wide a little hence it burst again with blood coming out from it. He the go back to his doctor and his doctor referred him to another doctor and telling him that maybe there is a possibility that he got fistula. We are so wooried Dr. CHUNG, but my brothers medical laboratories are all in normal result. His blood sugar, is normal, and even his biopsy is negative of a cancer cells.. What shall we do now Dr., We will just observe and pray for the healing of our dear brother.. Thank you doctor
How is his wound now? Was anything done to treat his would?
I just had my Fistulotomy today and this reassures my doubts. Thanks Dr! ❤️
Best of luck!
Hi there. Was wondering if you could give an update on your post op experience? It would be greatly appreciated.
Any update on ur recovery?
@@gigia3401 I had mine yesterday. Keep the stool soft postop would be my #1 advice. Eating lots of papaya, both green & ripe along with miralax, metamucil & 3 dulcalax stool softner. Stay away from laxatives though. The pain is less than Sphincterectomy. But still in pain. But again I m only on my 2nd day.
@@limgm.2551 hey how you doing now? and how was the pain after BM. Is the pain bearable
Can you please explain about perineal fistula
Tucks pads and prayer are saving me from surgery. So far
I have this with many tunnels two hospital said they couldn't help me what type of doctor do I look for ???
Thanks, Dr Chung - this is easy to understand.
Most Professional Lovely Doctor
Hi Dr.Chung, hoping you would answer me, Approximately how much is Fistula Surgery nowadays in the Philippines?
I hope philippines do have
You were able to explain it lightly. It lessens my worries. Maybe it is better to see actual surgery? And can you tell us the healing process? What kind of anesthesia need to be used.
Thanks
In Germany, they used general anesthesia for my surgery. It was not just a fistulotomy, they cut out the fissure that caused the fistula. First week was a little painfull, but really managable. First poop was scary. I had to use the shower head to clean the wound 4-5 times a day (and after every poop) for 4-5 minutes. Than put a dressing with ointment on the wound.
After about 3 weeks, the cleanings can be done less often, about 3 times a day. It's healed more or less so you can do everything like easy sports after 4-6 weeks, and the wound is completely healed after about 3 month.
But it was a resection of a fissure, as I said. The Dr. said, there are more chances it heals completely if they remove the cause.
so how can a CS determine where the fistula is to open up the skin in the right place?
Mri, endo anal scan, MR fistulogram
Hi Doc, your videos are very informative. I have gone through an abscess drain surgery for ischiorectal abscess and during the surgery my doc located fistula and installed seton. My healing is going really well and I saw my doc yday and he was very happy with the progress.
Q I have, my doc said I may have superficial or intersphincteric or transsphincteric fistula depending on how it heals, would he not know the kind already based on how he installed the seton already? I’m in complete trust with my doc but just trying to understand about the ambiguity around the fistula type. Thank you in advance!
How are you now?
Like the new format.
What promotes healing after fistulotomy? How long does pain/ discomfort last post fistulotomy?
Really starting to believe I may have an anal fistula …. it’s seriously so frustrating and depressing having to deal with abscesses that recur literally almost several at one time over and over again .. the cycle is so traumatizing and agonizing I just lose hope in seeing an end to this 😣
Symptoms?
@@559talk9 mostly recurring abscesses showing up every 1-2 weeks near my inner thighs, groin, an anus area. Tend to resolve on their own but mostly been using warm wet compresses to draw out the inflammation .. they usually vary in size and form generally in the same locations over and over again. I can tell when I’m getting one bc the area becomes slightly painful, a small bump appears and is painful to the touch also usually red.
@@graphicsguy2023 thank you. Do you have discharge? It’s pretty crazy but I have no pain or issues with bell movement I just notice after I pass stool a few hours later it’s damp on that area and kinda brownish discharge appears. No pain or blood. Not sure what it is
Hi dr.
I just want to ask ...what if the fistula is not superficial?
What are the difference?
Great explaination and easy to understand . Dr Chung , what is your views on laser treatment for fistula ?
Not sure yet. More long term data needed.
Is fistula below the dentate line all considered as superficial? I had a fistulotomy two years ago; it took me alsmot half a year to have completely no pus from wound healing. Dr 'flipped' open my wound for first month to ensure the open grove heals bottoms up like a V shaped welding layers. Since then I've been feeling the scar tissue has become easily irritable like a fissure, with feeling of itch, slight pain, swell etc every now and then. Is that possible?
Love your content, Mine bleeds every 3 weeks,is that normal
Mine does the same thing. Most of the time I don't even know it is there.
Great video. Thank you.
I can;t get my head around what they mean by the percentage of muscle involvement... how is it calculated?
I had my surgery last month and Im good now. I feel complete
How was recovery?
How was pain post surgery ?
dr chung i had skin tags ,removed them thinking my itchy and bleeding but the tags still came out and the itch still there i can feel a small pimple under the lower skin tag and is there where it itch, i,m using antifungal,antibiotic cream and is a bit better but the doctors when they visit me they say they don,t see or feel nothing it,s only me when i touch i feel a small pimple,can it be a fistula
Would a surgery for removal of fistula contribute to constipation by slowing down the contraction rate in colon?
Im from india.
Very good explanation..😊
Im lucky in this type.
Thank you
Hi! Did you get the surgery ?
Thank you for this video. How long would it take to recover from superficial fistula? My husband had surgery about 2months ago and still continues with some discharge and due to that moisture develops some sort of rash and redness on the inside of butt cheeks. Any advice would really help. His surgeon continues to tell him to give it time but it just seems too much .. he is constantly in pain and discomfort.
It varies. It's why I see my patients 2-3 times a week after this surgery.
My surgeon said it should b mostly healed by 2-3 weeks. 2 months sounds awfully long. Change your colorectal surgeon & see possibly two additional different surgeons to cross check what they suggest. Good luck!
Genious Doctor Chang.
I like the picture in picture - feels interactive. I see you are really improving the quality of your videos. Would the picture drawing work with an ipad/stylus instead, so you could be more carefree when drawing? I appreciate your constant improvements
Hi dr Chung I just wanted you tell me the symptoms of a fistula because I have painful defecation and throbbing after pain I do suffer from piles but this pain is different I have throbbing pain for hours after passing stool I am going for a sidmiostocopy on the 9th will a fistula or fissure show on this test. Could you let me know please no am desperate thankyou
What do you call it if it doesn't reach the skin only tuneless inside but not reaching the skin outside
Do i need an operation for fistula before having a hip replacement
I am diagnosed with anal fistula before one week, the surgeon after saw the mri said it hasn't touched the muscles so is superficial. They want 1600 euro to make the surgery, money which i don't have yet because i am a student and i don't have anyone to help me. My question is: What will happen with my fistula if i leave it for some time till i have the possibility to pay for it?, will it change directions or touch muscles?, or grow bigger?
Thank you
Hi hope you are doing well .. how are you now
Hi Dr. Chung,
I was recently misdiagnosed with having an Anal Fissure and after going for a second opinion was told I have a Superficial Anal Fistula.😮
So much PAIN & Drainage caused me to get the second opinion after being told the drainage was normal for an Anal Fissure I knew I wanted another opinion. The first Doctor told me I needed a follow up visit for him to inject Botox into it. Of course I didn’t have that done and I’m currently scheduled for the surgery 3/27/23 you mentioned in this AWESOME video.
How long will it take for me to return to work?
Thank you for this video!
Update?
You surely know now how long it took, but for others: I think, the pain level is different for everyone and every surgery is different. And it depends on your job. If it's a job that can be done from home lying in bed with your laptop, you can start sooner. If it's a job where you are physically active, it takes longer to be able to work the whole day.
Hello, several months later "I'm doing incredible!" The surgery was very successful and the recovery wasn't without some challenges! However, I did quite a few follow-up visits to my Doctor. I did experience so interesting things, which I found out was "normal" to the healing process. because I DID NOT want anything to grow back and the least little itch, slight pain or slight blood I made an appoint to be reexamined lol! So Far SO GOOD weeeeeesh! @@amritnalam9994
Great Point! So Grateful to be on the other side of this situation! Never that something so "small" can shift your life! "I cld write a book"!@@lenakohl2339
I have a small one on my tailbone Would it be able to hear on its own It popped now there's just a small hole?
Is it delicate to treat?
I had it complete disapperead , now i got it again ,omg i am nerous
Good morning
I have four anal fissure (4) procedures go in on my fifth (5) one . Is there a reason why I keep on getting anal fissures ? Also is there other treatment other than surgery ? At this time I am using C -Nifedipine 0.4% for a week now as prescribed by my doctor .
Would you recommend some other treatments ?
Thanks
Andy D
Your story is a bit more complicated since you had several procedures for your fissures. I would need more information to give a helpful response. Check the description box for video consult details if you are interested. I wish you the best.
What type of procedures did you have!! LIS is typically the gold standard for fissure & once should be enough or at most twice. 5th sounds awfully too many procedures.
Excellent information I just had an anal fistula (superficial) surgery and now I am taking rest after surgery and getting better, and I feel more energy and better vibes after this video. thank you I am so much happy, due to my sphincter muscles is not involved and the recurrence rate is below 5%. From Nepal
Hey, how you doing now? All ok?
And how were the first bowel movements. Pain bearable?
I hope u doing well ... how is going
@@ameernasri9761 I am good
@@Bikgyadid you have MRI to know it was superficial? Did you have fistulectomy or fistolotomy?
@@Bikgya How was your recovery from surgery, and total time?
Thank you for explaining
Two and 1/2 years ago I was diagnosed with a fistula and the doctor recommended that I take Phillips milk of magnesia. and without milk I can't take a bath and that worries me, what can I do? aid
What did the milk and magnesia help with? Any update on did you heal naturally did you get the surgery?
Why is leaving a seton for longer periods of time lead to better healing rate for a fistula after a fistulotomy?
Thanks for all your help
Any insight as to the signs it may be superficial vs going through the muscle that I may consider? Very anxious with fistula diagnosis, but need to wait for colonoscopy for surgeon to get the first look at it. Your videos have helped me understand what has been going on since the abscess.
Would you ever recommend or have your been trained on Fistula Tract Laser Closure (FiLaC) for more complex anal fistula?
Will a fistula / abcess result to sepsis?
Hi doc I just want to asked about ligation during fistulonomy is this the best procedure
Sorry, I'm not exactly understanding your question.
I believe he's talking about LIFT, Litigation of the Intersphincteric Tract.
I’m 1 week in after my surgery, I can tell I’m in the inflamed stage of the healing cause it’s itching like crazy. Hopefully it stops by next week or so.
any update will?
@@davidc2837 I’m actually glad you asked. I have a new one that showed its head but the first surgery wound has healed some. Definitely feels like melted flesh 😂
@@Scyffe how long were you symptomatic before getting the surgery? edit* I'm sorry to hear that too :( i hope you recover.
Great information! I believe I am having this at the moment, although I went to see a doctor and she said it was just an abscess and currently just prescribed me with antibiotics and lidocaine gel. But, somehow I thought maybe this was it because there was a palpable small mass from the small opening on the outside towards the anus
Thank you for all the information, i sure wish the proctologist that is doing my surgery in a week was more like you! My question is, if you were to perform a fistulatomy would you not want an MRI to see everything BEFORE you laid open the fistula? My surgeon told me thst she usually does not do MRI's ( i found this very odd) is this irregular? She scoped the rectum with a camera and she said it was a superficial fistula.. does that make her not need an MRI? I am very nervous i almost had to twist her arm to get the mri done and somewhar fearful if i havw the correct dr operating on me.
She also found a chronic fissure and recommended botox injection, will the expected incontinence go away fully? Will there be need for repeated injections ? Will there be any permanent change in the rectum?
I know i asked quite a few things but if you could help me with any of them it would reallt ease my mind.
These are all good questions. It seems to me you need to continue the discussion with your surgeon. You may also consider a video consultation with me as well. Wish you the best.
Hi @professionalviewer5672 how are you now?
Hi Dr, if I have superficial anal fistula should I take a change of surgery, please giving the advices. Thk 🙏
Can you see a fistula from outside? How does it look like?
@@kinnubuttardhillon7899 my doctor told me by insert his finger in anal, and verified that I have superficial anal fistula. I didn't see any from out side??
im one of the unlucky 50%. Been a year now dealing this, Im afraid AF to consult a doctor
Same here. I don’t think not trust any doctor.
what about after an abscess does that come from.the old wound site. my wound was never flat after now they suspect fistula. it's now drained through old abscess wound by becoming a tiny hole.
thank you for explaining about fistula
@@jwilde2769 how you doing now
Very well explained doc 👍👍
Thank you!
December Log: Campylobacter/food poisoning led to tooth ache, to constipation, to anal fissure so painful dentist refused to extract tooth when I sat in her chair. Now have watched more "Friendly Proctologist" reruns than all Jackie Gleason "Honeymooners" episodes ever syndicated. Wife refuses to listen of me explain finer points of differences of insoluble vs soluble fiber & importance of taking Miralax instead of Metamucil...
LOLOL!!! Holy moly that was so funny.
Hello doctor, I am a desperate, scared mother, 😭😭😭I have a problem with my little girl, I went to the doctor and he told me that she has a pilonidal cyst and a perianal fistula, I don't want the classic operation, I saw that minimally invasive methods without cutting, please help how can we proceed? what to do?help my daughter please😭😭😭 Thank You 🙏 🙏🙏
Thank you for this wonderful video Dr.Chung ! I have a question . So since the surgery is done really close to the anus , will it be really hard to poop after the surgery ? And what needs to be done ?
Aapke kya tha bhai ?
How are you now?
I was prescirbed pain killers and made sure to keep the stool soft. The first time was scary and took some time, but after a couple of days it was better than the discomfort I had before surgery.
Great information, explained so well. During the healing process of any anal issue….is adding epsom salt beneficial to sitz bath water?
I don't believe there is a benefit. But there's no problem with adding in the salt if you like it!
So - how can a person tell if they have a fistula ? Is there drainage at the skin end ?
Both ends
What about taking no action regarding it? I have been diagnosed with a superficial anal fistula while waiting for my anal abscess wound to heal for around one month.
Went poop yesterday. Dehydrated it was painful. Today i wake up with a pea sized knot on my bottem hole. Its been very painful, as im watching adjusting in my chair, the pain is suddenly gone. The pea knot is going away. Weird. Do i see a dr? Idk
My perianal feels irritated and raw and dry , what can it be ?
Thank you 🙏 ❤
Dr. Chung, this is very informative and helpful. I have a question tho. I have this pimple very near the anus opening. It keeps on coming back, I have checked our local doctor and gave me antibiotics twice, but is still recurring. There is mininmal to no pain at all and it bursts on its own. There are days/ weeks that the wound would close but there are days where a pimple keeps coming back on the same spot. Is this fistula already?
It's possible. I recommend seeing a specialist near you for a proper diagnosis.
How are you doing now ? I might have same issue
@@sanpat2220 I still have it, it comes for a few days and goes for a few days.
@@zosefsotheoherrero171 how you doing now
@zosefsotheoherrero171 .... You got your diagnosis now? Update?
Would a tooth abses cause inflammation in other parts of the body. Removed my crown with root canal and now have an anal abscess
What's typically the healing time after a fistula surgery? And how is the pain during recovery ?
usually 4-6 weeks. depends on what was done in surgery.
Is there a complete cure? Cause doctor told me there’s 50/50 chance that I’m healing and recover 100% from it
Really understood.
Now Doc, show us how scar looks like after Filac laser on Fistula in ano.
Hi, Doc. If i have superficial anal Fistula should i take surgery or just leave it alone. Thk
Thank you doctor
I just got operated today with laser from a fistula, but got a huge piece of "ass" missing, is it gonna regenerate?
You will need to speak with your surgeon about your surgery. Wish you the best.
How are you doing now??
@@sanpat2220 almost done, it Indeed regenerated, it's been a slow recovery but with no pain
@@AdlvRegnum hey how you doing now? and how was the pain level during BM
I had a pimple next to wear i poop. It didnt hurt when i pooped but it did feel wierd when ill walk. It hurted for a couple days and i started putting alcohol on a paper towel every time i came out the shower. It went down and andd no pain no nothing .. like 3 days after i started feeling like weird on like the top of my butt crack like bumbles inside my anal is not hurting but like the inside of my lower back is started to feel like some irritation.... Tomorrows my day off im going to the clinic to see a doctor in so scared i seen pictures of surgery omg 😭.... Can u help with anything ill REALLY REALLY APPRECIATE IT !
What if they are bleeding?
My abcess had to be drained and my primary care physician put the hole far away from the anus sadly. I just had a cutting seton installed by my CRS today and i cant help but feel like my PCP screwed up and made the tunnel bigger and more likely to go through muscle
Is it possible to have anal fistula,without an exit wound outside the skin??? Or just a hard
Hey doc, so I recently had a colonoscopy. He noted I do have a fistula but it hasn’t bothered me since it happened. And the external opening isn’t far from my actual anus. He recommended I get it fixed eventually. But wanted to ask your input.
Hard for me to say without more detail. Look in the description box if you are interested in a video consultation.
Compliments Doctor, I greatly enjoy your channel. I have been diagnosed of anal fissure that has lasted for some time, my doctor has sent me for a colonoscopy and am so scared of having it, because the anal area is still inflamed