Rectal Fistulotomy

Medically reviewed by Drugs.com. Last updated on Apr 2, 2024.

A rectal fistulotomy is surgery to heal a fistula near your anus. A rectal fistula is a tunnel-like wound that forms next to your anus. It spreads from inside your rectum to the skin surface near your anus. A rectal fistulotomy is used to open and drain the fistula. The wound heals by filling in with scar tissue. Your surgeon may also drain an abscess during your surgery.

DISCHARGE INSTRUCTIONS:

Seek care immediately if:

You are not able to urinate within 8 hours of surgery.
You have increasing pain, redness, and swelling on skin near your anus.
You have nausea and are vomiting, and you cannot drink liquids.
You have more bleeding, swelling, or pain than you were told to expect.
You have pus or blood that drains from your wound and does not stop.

Call your doctor or surgeon if:

You urinate less often than usual.
You have pain when you urinate. This may mean you have a urinary tract infection.
You have a fever.
You are constipated.
Your wound is not healing as it should.
You have drainage that does not stop.
You cannot control your bowel movements or gas.
You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
Stool softeners makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.
Antibiotics help fight or prevent a bacterial infection.
Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Care for your surgery area:

Remove any bandages near your anus the next day. You may have some gauze inside your rectum that will fall out on its own or be removed by your healthcare provider. Clean the area as directed.

Self-care:

Your wound should heal within 4 weeks for a minor fistula or 16 weeks for a complex fistula. The following can help you heal:

Follow nutrition recommendations. Drink only clear fluids until you start having bowel movements again. Ask when you can eat regular foods. Eat high-fiber foods when your healthcare provider says it is okay. Examples of high-fiber foods are fruit and whole grains.
Limit activity as directed. Ask when you can return to your normal daily activities.
Do not smoke. Nicotine and other chemicals in cigarettes and cigars can slow healing and cause lung and heart damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
Take sitz baths. Sit in a sitz bath or take tub baths in warm water. Do this 3 to 4 times each day for 15 to 20 minutes each time, or as directed. A sitz bath is a clean pan that holds warm water and fits in your toilet bowl. Sitz baths help keep your wound clean and may ease your pain.
Prevent constipation. Do not stop yourself from having a bowel movement. Drink more water. This will help your bowel movements stay soft and make them easier to pass. Exercise also helps your digestive system work better so you prevent constipation.

Follow up with your doctor or surgeon as directed:

You will need to be watched closely after surgery to make sure you do not get sepsis. This is a dangerous blood infection caused by bacteria that can be life-threatening. You may also need to have your seton removed after your surgery. Keep all your follow-up appointments. Write down your questions so you remember to ask them during your visits.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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