FISTULA

Hey friends.. I have asked this question last year--but did not get any answers really and the doctors certainly will not explain it all to me.. I had an endoscope done my esophogus and into my pouc h and the gastro doc who did it found 3 polyps in my pouch--a loose staple and what they call a Fistula.. Which i had not idea what a Fistula was--did some research--not much to find and all that i know even after going down to see the Weight Loss surgeon--al i was told is that it a branch like thing that grows out from your stomach pouch out to your old larger part of your stomach and intestines and was showed the picture of the endoscope of the inside of my pouch--which looked like a hole--the intern explained that that was the fistula and it is like a hollw branch that grows ou and arraches to the old part of your stomach--i guess there are other kinds of fistulas--i found out that this fistula was cause by a mechanical failure of your RNY--on an article here on OH.. I was  so stressed out about this fistula and loose staple that i had to just stopped thinking of it--cause there was no way they were gonna admit it was caused by the surgery..Now i cannot say that my surgery was a failure cause i lost over 200 lbs--But i started gaingin weight and aske back then if this fistula can cause me to lose weight and if this lose staple can fall out and cause trouble--just got a snotty answer--or they can or they cannot.. I am still gaining weigh little by little--Now i have kidney disease so i do gain fluid one week and the nex week it is gone..Now i am up like 20 lbs and so scred that i will get Morbid again..Can anyone please share with me their experiences with a fistula--cause i heard from one woman who said it cause a bad infection in her body that almost killed her-- Can this fistula be removed or do I have to have a total new Revision--which i am trying to avoid// ..Hpw dangerouis is this fistula??? I had an colonoscopy a few months ago and i have 1 polyp in there which came back clean like the others last yr--and i have internal hemorrhoids.. I have been having blood in my stool for he past couple of days and i am assuming it is the hemorrhoids..But then now I am wondering if that FISTULA has anything to do with it or that Losse staple might have come out..
Pleaase Please help me--People have sent me articles about this and they really do not anser any questions directly.. Is this commom to have a Fistula?? I really need some answers as it is getting hard to ignore this anymore,Hugs Susie Smith from PA 

Susie, I had never heard of a Fistula until now. I googled it and I found this one site that says this:

Gastric fistula - occurring in up to 4% of bariatric surgery patients, a gastric fistula is an abnormal passage that leads from an abscess or hollow organ or part to the body surface or from one hollow organ or part to another.12 Sepsis can follow, and surgery is usually required to fix it.

Gastric fistulas are associated with the stomach (i.e. 'gastric'). However, not all fistulas are associated with the stomach, and other types can occur (such as from an intestine to intestine anastomosis.)
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If it were me, someone would be giving me some answers. If this needs to be revised or fixed or whatever, you need to get them to do it. They have no right to act snotty towards you for simply asking questions about your situation. Sepsis is VERY serious so don't take this lightly.

Tomorrow call your surgeon and tell him you need to get this Fistula fixed (and get rid of the loose staple and fix it too.

No one wants another surgery, trust me, I just had a revision and it's not been fun at all, but sometimes you gotta do what you gotta do.

God bless and protect you Susie. Keep us updated on what you find out.

Wynter

Thank you so much for taking the time to look things ups for me-I do appreciate it..I was so firm and angry to the surgeon last yr and did not get anywhere and he explained to me that a Revision could kill me--as I almost died when i had my RNY--I have enough problems with diabetic complications like kidney disease and such--that is why this is all starting to make me worry again about it..There is another surgeon who is not associated with the Geisinger doctors in my area that I have to check into to see if my insur will cover him--i am afraid it might--I just do not want to end up in an emergency situation.. Thank you and God Bless you--Susie SMith from NE PA

Maybe you need to find another surgeon and get a second opinion.  It sounds like your current medical team is not very helpful.

Thank you for responding--i appreciate all opinions and aadvice.. Prayer t

A fistula is basically an abnormal connection between 2 organs.  Depending on the 2 organs and how large they are, determines if something or anything needs to be done.  This past winter I had multiple surgeries due to complications and post op, they thought I had a fistula because my incision which had to be left open to heal, had stool coming out of it.  So, they rushed me into CT Scan and thank goodness the test was normal and no fistula. I dont' remember the explanation, I was pretty out of it and all was better within 2 days.

Then a couple of months later when I had another surgery and my pain wouldn't go away post op, my surgeon said there is a good chance that I have a fistula.  She said that based on my symptoms and amount of pain I was having with no fevers, that if I had one - it would be a small one.  So rather than put me through a ton of radiation for something that didnt' need to be treated, she just left it alone.  She said just large ones need to be treated.  I also spoke to my urologist recently and she said that fistulas between the intestines and bladder have to be surgically repaired.

I would definitely ask more questions and get a second opinion.

good luck

Questions I would ask your & a new surgeon:

-Is there any possibility that the fistula can be come a leak? (leaks are definitely life threatening)
-How wide is the fistula can food / fluid pass through into my remnant stomach? (if so, this could cause weight gain, undermine loss and could seriously upset your gut flora making you more susceptible to pain and ulcers.)
-What can be the specific complications of this fistula?
-What are the symptoms of those complications?
-What is involved in a surgical repair?
-What are the complications of a repair surgery?
-Why did I "almost die" when I had my RNY, and what is the possibility of that occurring again?
-Can it cause blood in my feces?

And if your doctor won't answer them thoroughly and completely, I'd keep asking new doctors until someone did. Take a notebook or a voice recorder and take a LOT of notes.

Just my opinion and I am not a surgeon, but I don't think that the repair will be a whole revision. I do think it will be aa surgery though - you will likely have to go under general anaesthesia and they will either restaple or medically fuse the staple line.

Good luck!

I asked all those questions and the surgeon and his intern and his Nurse Pract. all said that they cannot tell --this could happen or it may not--that was the answers i got.. They cannot predict what may happen they said..I said well what am I supposed to do--what until I am in an emergency situation  or what?? No real answers I got.. I got my surgery in Danville PA--and there is a surgeon in my area who is not associated with Geisinger--but he does not take my insur.. I cannot travel farther then Danbille..Maybe I can check out Hershey Med Center in PA..  My neuropathy in my legs is getting worse and it is harder for me to get around--I depend on my huby to be my chauffer LOL and he takes so many of his vacation days just to take me to the doctors--as I hae like 6 doctors. I just am so confused sometimes.. I asked if this fistula can cause me to gain weight also and they said again like the other questions--it could or it could not.. I just want straight out answers thats all.. And weigh my pros and cons.  Thanks for writing me--it feels good to have friends who understand what life is like after Weight Loss surgery..HUGS and Prayers--Susie Smith from NE PA 

WELL I CALLED AND MADE AN APPT WITH THE GI NUTRITION TEAM--THEY HAVE A DIFFERENT DOCTOR OF NUTRITION I CAN TALK TOO ABOUT ALL THIS--SHE IS SUPPOSED TO BE NICE.. I AM NOT A GLUTTEN FOR PUNISHMENT (i think( BUT IT HAS BEEN OVER A YEAR SINCE THEY FOUND THIS FISHTULA RUNNING FROM MY POUCH TO MY OLD PART OF MY STUOMACH AND I WANT TO KNOW IF IT IS WORSE AND WHAT CAN BE DONE ABOUT IT.. I HAVE AN APPY ON SEPT 26.. WE WILL SEE.. I HOPE I DO NOT REGRET THIS... THANKS FOR HELPING ME MY WEIGHT LOSS FRIENDS..GOD BLESS--SUSIE SMITH FORM NEPA PRAYERS TO YOU ALL. 

From what my surgeon told me, the large ones cause major symptoms and need to be treated immediately with surgery.  Smaller ones tend to heal in time by themselves. I tend to think that if you had over a year with no trouble that it is probably gone by now - healed up. I really think you would know by now if things got that much worse.