Love Goddess,

I was diagnosed several years ago with an anal fistula.  They used an acid stick to "weld" it closed a number of times, but now they say I need surgery.

The doctor they sent me to speaks very little English and even that is hard to understand.  What am I in for?  They say it is pretty bad and lord knows I am constantly losing blood and having problems controlling excretion in that area.

What are the options for surgery and is there any alternative treatment?  What kind of recovery time is involved and what limitations are involved?

The last question I have comes from a comment the Dr. who first diagnosed this problem raised.  She asked me if I participated in receiving anal sex or if I was ever anally molested when I was young.  Can this be caused by that?  

I ask because I have never received anal sex as an adult, but I was repeatedly anally molested by my older brother when I was just 10-11 years old and if this was a result of that, I would really like to know.

Thanks in Advance Love Goddess

Dear A Null Problem,

I understand that this is a problem for you. Not being a physician, I can merely provide a textbook answer, which I have done in the provided link.

Yes, the condition may have been a result of the repeated anal injury you received. The clinical literature documents such injuries on pre-pubescent females who have been victims of sexual abuse. Since fistulas in female children are rare, abuse has been implicated as a factor.

On a separate note: I hope you have received some psychological counseling for these issues and that you have been able to go on with your life in a healthy and productive manner. Incest is no small matter, even if perpetrated by young siblings.

I hope you will recover 100% soon,
the Love Goddess

in Africa, due to abuse, botched genital mutilation, poor hygiene, etc.  Treatment is hard to come by, and those with the condition are usually ostrasized from family and community.

I am an Internal Medicine physician in Los Angeles.  Anal Fistualas are a serious problem, not just an imbarrassing one.  But they can be fixed and heal completely.  Please, find a "colo-rectal" surgeon.  Do not use a plain general surgeon or any other MD.  Find a guy who does nothing but colo-rectal surgery.  Here is a good place to start [http://www.fascrs.org].  The American Society of Colo-Rectal Surgeons has a doctor finder on this website.  There are not a huge number of these specialists, but they are well worth your searching them out or waiting for an appointment.  You may have to go to a regional medical center to find one, but get yourself to one of these guys.  You should be able to find one who speaks english.  Every one I have ever met has been the nicest guy and their patients love them. You don't want an amature working on this area of your body.  Old general practioners used to make a mess out of treating hemrhoids, anal abcesses and fissures.  Complications of an anal fistula or a botched surgery can include serious infections, anal strictures and incontinence the rest of your life.  

Recovery depends on the extent of the surgery required and can vary depending on how long it has been there, how big it is, and how much surrounding infection, abcess or hemrhoids have developed.  Many times, its an office procedure quick an easy, but requires a few weeks for complete healing.  

Until you see the expert, keep your stools very soft.  Do not let yourself get constipated.  This will make things worse.  Take Colace 100mg twice a day or 200mg twice a day (or docusate 250 twice a day or 500mg per day) [ask a pharmacist, both drugs available over the counter without a prescription], drink plenty of fluids, use prunes, prune juice or senna (also available without prescription), but keep your stools loose.  Keep your ass clean.  Sit in a tub of warm bath water twice a day if you have to (this often helps the pain as well).

These things are not always related to trauma or rectal intercourse.  I would think that if this were an outcome of a childhood incident, it would have caused some problems all along such as hemrhoids, rectal fissues or abcesses along the way. Sometimes they just happen or are a complication of hemroids, rectal abcesses, or fissures that got out of hand related to diabetes, chronic constipation or diverticulosis/diverticulitis.  But there is a higher incidence of these things in those who practice anal intercourse.  Hope this helps.

eom

This has been an ongoing problem for quite some time and they have tried treatments other than surgery, but have finally decided that after years of having amatuers playing around with my leaking infected ass, that it was finally time to go to a specialist.

I appreciate your advice.  And thanks for the info.  I just hope that the bungled treatments up to now have not caused damage that will make the new surgery difficult, or unsuccessful.

-- Modified on 4/3/2007 6:06:21 AM

"The popular idea of mathematics is that it is largely concerned with calculations," writes Karl Sabbagh in The Riemann Hypothesis (Farrar, Straus and Giroux). "What many people don't realize -- and mathematicians at parties have given up correcting them -- is that mathematicians are often no better calculators, and sometimes worse, than the average non-mathematician. . . . Even the giants of mathematics suffer from this minor disability: 'Sir Isaac Newton,' said one observer, 'though so deep in algebra and fluxions, could not readily make up a common account; and, when he was Master of the Mint, used to get somebody else else to make up his accounts for him.' "
Source: The Chronicle of Higher Education

Einstein got a D in math one year.

Thanks for taking the time to write all of that out.  Very considerate.  Maybe we need a Physician's corner?  Hmmm