Patient education: Enteric fistula (The Basics)

What is an enteric fistula? — 

This is an abnormal connection that forms between a part of the intestines and another part of the body. It can form after a person has surgery. It can also happen without surgery in some cases, such as from inflammatory bowel disease.

The 2 common types of enteric fistula are:

●"Enterocutaneous" fistula – This is a connection between the intestine and the skin.

●"Entero-entero" fistula – This is a connection between 1 part of the intestines and another. It can form between small intestine and small intestine, small intestine and large intestine, or large intestine and large intestine.

Enteric fistulas can also cause abnormal connections with other body parts. Examples include the uterus, bladder, or blood vessels. The symptoms and treatments of these kinds of fistulas are different from the kinds of enteric fistulas described in this article.

What are the symptoms of an enteric fistula? — 

The symptoms depend on the type of fistula:

●Enterocutaneous fistulas can cause leakage of the intestines through an opening on the skin.

●Entero-entero fistulas can cause a swollen and tender belly, fever, or diarrhea.

Is there a test for an enteric fistula? — 

Yes. Your doctor or nurse will probably be able to tell if you have one by learning about your symptoms and doing an exam. But you might need tests, including:

●A CT scan – This is a special kind of X-ray. It creates a picture of the inside of the body.

●A fistulogram – The doctor injects a dye into an opening in the fistula and then takes an X-ray. This helps them see where the fistula goes.

These tests help the doctor figure out where the fistula is. Sometimes, tests can also help them find the cause.

How is an enteric fistula treated? — 

At first, treatments can include:

●Fluids, medicines, and nutrients – These can be given through a thin tube that goes into a vein, called an "IV." They help replace fluid that is lost through leakage of the intestines or diarrhea. If you have an infection, you might also get antibiotics.

●Inserting a drain – If you have an infection, your doctor will insert a tube through your skin and into your belly or pelvis. The tube is used to drain the infected fluid. They will likely do this in a procedure room, using a CT scan or ultrasound to guide where to place the tube. The tube stays in until all the fluid has been drained. This usually takes several days to weeks.

●Wound care for an enterocutaneous fistula – This involves careful cleaning and using special dressings. The goal is to collect leaking fluid and protect the skin from irritation or infection.

Many enteric fistulas heal after these treatments. But if your health gets worse, or if your fistula does not heal as quickly as it should, you will likely need surgery. Surgery for a fistula is usually complicated. It can take a long time to recover, and it can cause more health problems, such as another fistula.

More on this topic

Patient education: Rectovaginal fistula (The Basics)
Patient education: Anal abscess and fistula (The Basics)