For this topic I'm gonna quote Wiki first: a fistula is an abnormal connection or passageway between two organs or vessels that normally do not connect.
Did you know a fistula can occur from head to toe?
With Crohn's fistula's usually occur:
- Anal (perianal), these connect the anal canal to the surface of the skin near the anus
- Bowel to bladder (enterovesical or colovesical)
- Bowel to vagina (rectovaginal)
- Bowel to skin other than near the anus, like the abdomen (enterocutaneous)
- Between bowel and or intestines (enteroenteric or enterocolic)
About 1 out of 3 people with Crohn's will sooner or later develop a fistula(or two). Fistula's are much rarer in people with Colitis.
I have a fistula in what they so clinically call the perianal region. That means the fistula is near my rectum. When I have to discribe to people what it is, I always have two kinds of explanations:
- it's like a pacman. A pacman (bacteria) has been eating it's way through my inflamed bowel wall searching for a way out. Don't ask me why but this pacman just kept eating his way down to my butt, of all places. Guess he thought this was a shortcut. The path he has created is what we call a fistula;
- it's like the white nerve you see in steak.
The longer version is that the inflammation with Crohn's can spread through the whole thikness of the bowel wall. When this happens particularly in the lower part of the bowel it can cause small leaks and abscesses(collections of pus). As the abscess develops it may 'hollow out' a chamber or hole. This then becomes a passage or channel linking the bowel to another loop of bowel, another organ, or the outside skin. When the abscess bursts, the pus will drain away, but the passage or channel may remain as a fistula.
*Above a MRI of a Fistula, the white stuff you see is the Fistula track
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