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Gastrointestinal Fistula

WHAT YOU NEED TO KNOW:

What is a gastrointestinal fistula?

A gastrointestinal (GI) fistula is an abnormal opening in your stomach or intestines. Fluids from your stomach and intestines leak into other parts of your body through the opening. They can leak into other organs or through your skin to the outside of your body. A GI fistula can lead to infections, malnutrition (not enough calories or nutrients), or dehydration.

What causes or increases my risk for a GI fistula?

  • Abdominal surgery such as bariatric surgery
  • Inflammatory bowel disorders such as Crohn disease
  • Medical conditions such as ulcers, pancreatitis, or cancer
  • Radiation treatment in the abdomen
  • Abdominal trauma such as a stab wound

What are the signs and symptoms of a GI fistula?

The signs and symptoms of a GI fistula depend on where it is located. You may not have any symptoms, or you may have any of the following:

  • Abdominal pain or bloating
  • Diarrhea
  • Weight loss
  • Nausea or vomiting
  • Heartburn
  • Fluid leaking from an open wound in your abdomen

How is a GI fistula diagnosed?

  • An endoscopy is a procedure used to look at the inside of your esophagus and stomach with a scope. A scope is a flexible tube with a light and camera on the end. Your healthcare provider may remove a small sample of tissue and send it to a lab for tests.
  • A colonoscopy is a procedure to look at the inside of your colon with a scope. A scope is a flexible tube with a small light and camera on the end is used. Your healthcare provider may remove a small sample of tissue and send it to a lab for tests.
  • An x-ray of your upper and lower intestines may be done. Contrast liquid will be given so that healthcare providers can see your intestines more clearly.
  • A fistulogram is an x-ray of a fistula that goes through your skin to the outside of your body. Contrast liquid will be injected into the open wound to help your providers see the fistula better.
  • An ultrasound, CT, or MRI may be used to take pictures of your stomach and intestines. The pictures may show the location of your fistula. You may be given contrast liquid to help healthcare providers see the fistula better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is a GI fistula treated or managed?

Treatment depends on the cause of your fistula, and the type of fistula you have. You may need treatment for a medical condition that caused your fistula. Some fistulas may close on their own. You may need any of the following:

  • Antibiotics may be needed to treat or prevent a bacterial infection.
  • Nutrition support may be given through an IV or through a tube that is put into your nose (nasogastric tube). This will help you get the nutrition you need while your fistula heals.
  • Negative pressure wound therapy (NPWT) may be used to heal fistulas that go to the outside of your body. NPWT uses a machine called a wound vac, wound vacuum, or pump to help with wound healing. Suction from the machine removes excess drainage from your wound and pulls wound edges closer together. NPWT promotes healthy tissue growth by increasing blood flow to your wound. NPWT also reduces bacteria that causes infections.
  • Surgery may be needed to close your fistula. Surgery may instead be done to remove the part of your intestines that contains the fistula. A skin graft may be placed over a fistula that goes to the outside of your body.

When should I seek immediate care?

  • You have severe vomiting or diarrhea.
  • You have heavy bleeding from your rectum.
  • Your abdomen is larger than usual and very painful.

When should I contact my healthcare provider?

  • You develop any new symptoms.
  • You have a fever.
  • You are losing weight without trying.
  • You notice a change in your bowel movements.
  • You feel depressed, confused, tired, irritable, and you do not feel like eating.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.

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