Can Unformed Stool Lead to Fistula Development? Expert Insights

Can unformed stools lead to the development of a fistula?

Hello, doctor… I had a fistula drainage surgery two months ago, and the wound is almost healed now.
However, I am worried about a recurrence.
I found information stating that inflammation of the anal glands can lead to the formation of a fistula.
I would like to know if my long-term experience of having unformed stools, which tend to stick to the toilet and are dark in color, could be a contributing factor.
I do have a bowel movement every day, usually around 6 AM.

1.
Could long-term unformed stools be a factor in the development of my fistula?
2.
How long does it typically take for a fistula to form? (I want to understand why I developed a fistula to avoid it in the future, but the surgeon who performed the operation could not explain the reason.
I do not excessively clean myself; I only used toilet paper for cleaning after bowel movements and did not use water.
Could this be a contributing factor?)
3.
After my surgery, there is a hard tube extending from the wound to the anus under the skin.
The doctor mentioned that it is a scar from the drainage method used.
Is it normal to have this tubular scar after surgery?
4.
How can I prevent the recurrence of a fistula? Would continuing warm sitz baths after healing help? Or would taking traditional Chinese medicine for conditioning be effective? (Currently, the wound is not painful or itchy, and there is no discharge; only a cotton swab is left deep in the wound.)
Please help me clarify these concerns, doctor…

Ms. Huang, 30~39 year old female. Ask Date: 2017/02/19

Dr. Ke Fangxu reply Surgery

1.
No.

2.
Fistulas are usually sequelae that develop after an infection, typically starting to form around three months after the infection.
The vast majority of people use toilet paper for hygiene, but only a minority develop fistulas, indicating that there is no direct correlation.

3.
Yes.

4.
Maintaining cleanliness and good bowel habits is sufficient.
Traditional Chinese medicine is not my area of expertise, so I cannot comment on it.

Reply Date: 2017/02/19

More Info

The development of anal fistulas can be a complex issue, often stemming from various underlying conditions, including inflammation of the anal glands. Your concern about the relationship between unformed stools and the potential for fistula formation is valid, and I will address your questions in detail.

1. Can Long-Term Unformed Stool Lead to Fistula Development?
Yes, long-term unformed stools can contribute to the development of anal fistulas. When stools are not well-formed, they can lead to increased irritation and inflammation in the anal region. This irritation can cause the anal glands to become blocked or infected, which may eventually lead to the formation of an abscess. If this abscess does not heal properly, it can create a fistula, which is an abnormal connection between the anal canal and the skin. The consistency of your stools, especially if they are loose or fragmented, can exacerbate this irritation and increase the risk of complications.

2. How Long Does It Typically Take for a Fistula to Form?
The timeline for fistula formation can vary significantly from person to person. In some cases, a fistula can develop within a few weeks following an infection or abscess, while in other cases, it may take months or even years. The key factors influencing this timeline include the severity of the initial inflammation, the presence of any underlying conditions (such as Crohn's disease), and how well the area is cared for post-surgery. Since you mentioned that you had surgery two months ago, it’s essential to monitor your symptoms closely and maintain good hygiene to prevent recurrence.

3. Is It Normal to Have a Hard Tube Under the Skin After Surgery?
After surgery for an anal fistula, it is not uncommon to have a hard tube or cord-like structure under the skin, especially if a seton (a type of drainage device) was placed to allow for continuous drainage and healing. This is part of the healing process, and while it may feel unusual, it is generally considered normal. However, if you experience increased pain, swelling, or discharge from the area, it is crucial to consult your surgeon for further evaluation.

4. How Can I Prevent Fistula Recurrence?
To minimize the risk of fistula recurrence, maintaining good bowel habits is essential. Here are some strategies that may help:
- Dietary Adjustments: Incorporate a high-fiber diet to promote well-formed stools. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying well-hydrated is also crucial.

- Regular Bowel Movements: Establish a routine for bowel movements to avoid straining, which can further irritate the anal area.

- Hygiene Practices: After bowel movements, consider using gentle cleansing methods, such as warm water rinses or sitz baths, to keep the area clean without causing irritation.

- Follow-Up Care: Regular follow-ups with your healthcare provider are essential to monitor your recovery and address any concerns promptly.

- Alternative Therapies: While some individuals explore herbal remedies or traditional Chinese medicine for digestive health, it’s essential to discuss these options with your healthcare provider to ensure they are safe and appropriate for your situation.

In conclusion, while unformed stools can contribute to the development of anal fistulas, maintaining a healthy diet and proper hygiene can significantly reduce your risk of recurrence. If you have ongoing concerns or symptoms, do not hesitate to reach out to your healthcare provider for personalized advice and management.

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