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What causes hardness in fistula tract after fistulotomy?

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Posted on Wed, 25 May 2016
Question: Hello Doctor ! i had a fistulotomy a month back. The fistula was simple in 3'o clock position. As per surgeon's advice, after the operation the wound was left open to heal by itself. I consulted you on the same and as you prescribed i have been using betadine (povidone iodine) twice a day after sitz bath. Even though i have stopped the stool softners, the stool is normal and i have no constipation.
Now the opening is completely closed and i dont feel any pain. the tract is hard and i can feel the tract. but there is no pain in it.the swollening has come down.
1. Why is the tract still hard? has it not got healed inside.
2. How do i ensure that i have got rid of the fistula tract
3. Do i need to scan once to confirm it.
4. Is there any way to prevent fistula from reocurrance.
doctor
Answered by Dr. T Chandrakant (57 minutes later)
Brief Answer:
as explained in details.

Detailed Answer:
Hi.
Thanks for your review query.
Nice to know that the stool is normal even without stool softeners, the opening is completely closed and there is no pain.
Also noted that you can feel the tract and is hard, swelling has come down.

To answer your queries in details:
1. Why is the tract still hard? has it not got healed inside.
> The feeling of a cord like hardness means the fibrosis is good and absence of pain, tenderness, reduced swelling and no localized changes indicate that the treat id nicely healed with fibrosis, a natural healing process in this area.

2. How do i ensure that i have got rid of the fistula tract
> The above description and absence of any symptoms is indicative of that you have got relieved of the tract.

3. Do i need to scan once to confirm it.
Ideally speaking, there is no need to have any review scan or so in the absence of the symptoms or signs.
Yes, High resolution ultrasonography or MRI will confirm it.

4. Is there any way to prevent fistula from recurrence.
If the healing has occurred with well formed fibrosis, there can not be any recurrence.
Maintaining good motion and avoiding infection of the intestinal tracts by having fresh home-made foods and beverages endure no recurrence.

I hope this answer helps you, please feel free to ask any further relevant queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19381 Questions

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What causes hardness in fistula tract after fistulotomy?

Brief Answer: as explained in details. Detailed Answer: Hi. Thanks for your review query. Nice to know that the stool is normal even without stool softeners, the opening is completely closed and there is no pain. Also noted that you can feel the tract and is hard, swelling has come down. To answer your queries in details: 1. Why is the tract still hard? has it not got healed inside. > The feeling of a cord like hardness means the fibrosis is good and absence of pain, tenderness, reduced swelling and no localized changes indicate that the treat id nicely healed with fibrosis, a natural healing process in this area. 2. How do i ensure that i have got rid of the fistula tract > The above description and absence of any symptoms is indicative of that you have got relieved of the tract. 3. Do i need to scan once to confirm it. Ideally speaking, there is no need to have any review scan or so in the absence of the symptoms or signs. Yes, High resolution ultrasonography or MRI will confirm it. 4. Is there any way to prevent fistula from recurrence. If the healing has occurred with well formed fibrosis, there can not be any recurrence. Maintaining good motion and avoiding infection of the intestinal tracts by having fresh home-made foods and beverages endure no recurrence. I hope this answer helps you, please feel free to ask any further relevant queries if you feel that there is a gap of communication.