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Fistula: Latin for “bad news”

Posted Nov 04 2009 10:04pm

Okay, no, it doesn’t actually mean “bad news”… it means “tube”.  I had my followup today with Dr. Kaplan, and was informed that the ultrasound found a fistula in my small intestine.  A fistula is essentially an abnormal passageway that forms between two types of tissue lined with epithelium… in this case, it’s actually between two loops of bowel.  This is bad because a) it indicates that the Imuran is not working and that my Crohn’s is growing to be more aggressive, and b) there are a host of bad complications that can arise from fistulas, such as infections or perforation.  And we all know I’ve been through that before.  The surgery to fix a fistula means potentially losing more bowel tissue.

Obviously, I don’t want to need repeated resections.  The problem with resections is that eventually you’ll just have to get an ostomy, and I just don’t think I’m ready to deal with the thought of wearing a colostomy bag. 

So, once more, the dreaded R word has come up.  The best medication for fistulizing Crohn’s is Remicade, a very expensive intravenous medication.  And upon doing a bit of Internet research, I’ve found a lot saying that fistulas need to be corrected with surgery… Dr. Kaplan didn’t say a word about surgery, however I am scheduled for a barium swallow to determine the extent of my fistula.

Kyle and I haven’t really hashed all this out in too much detail yet, so I don’t have much news about what action we’re going to take here- we’re just dealing with all the information I’ve been given today. 

Suffice it to say, I kinda figured that my clear results from my colonoscopy didn’t mean I was disease-free, as I haven’t been symptom-free. 

Prayers would be much appreciated- it’s scary for me to realize that my Crohn’s has become this aggressive.

Okay, no, it doesn’t actually mean “bad news”… it means “tube”.  I had my followup today with Dr. Kaplan, and was informed that the ultrasound found a fistula in my small intestine.  A fistula is essentially an abnormal passageway that forms between two types of tissue lined with epithelium… in this case, it’s actually between two loops of bowel.  This is bad because a) it indicates that the Imuran is not working and that my Crohn’s is growing to be more aggressive, and b) there are a host of bad complications that can arise from fistulas, such as infections or perforation.  And we all know I’ve been through that before.  The surgery to fix a fistula means potentially losing more bowel tissue.

Obviously, I don’t want to need repeated resections.  The problem with resections is that eventually you’ll just have to get an ostomy, and I just don’t think I’m ready to deal with the thought of wearing a colostomy bag. 

So, once more, the dreaded R word has come up.  The best medication for fistulizing Crohn’s is Remicade, a very expensive intravenous medication.  And upon doing a bit of Internet research, I’ve found a lot saying that fistulas need to be corrected with surgery… Dr. Kaplan didn’t say a word about surgery, however I am scheduled for a barium swallow to determine the extent of my fistula.

Kyle and I haven’t really hashed all this out in too much detail yet, so I don’t have much news about what action we’re going to take here- we’re just dealing with all the information I’ve been given today. 

Suffice it to say, I kinda figured that my clear results from my colonoscopy didn’t mean I was disease-free, as I haven’t been symptom-free. 

Prayers would be much appreciated- it’s scary for me to realize that my Crohn’s has become this aggressive.

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