A gastrointestinal fistula is an abnormal opening in the stomach or intestines that allows the contents to leak to another part of the body.
- Leaks that go through to a part of the intestines are called entero-enteral fistulas.
- Leaks that go through to the skin are called enterocutaneous fistulas.
- Other organs can be involved, such as the bladder, vagina, anus, and colon.
Entero-enteral fistula; Enterocutaneous fistula; Fistula - gastrointestinal; Crohn disease - fistula
Most gastrointestinal fistulas occur after surgery. Other causes include:
Depending on where the leak is, these fistulas may cause diarrhea, and poor absorption of nutrients. Your body may not have as much water and fluids as it needs.
- Some fistulas may not cause symptoms.
- Other fistulas cause intestinal contents to leak through an opening in the skin.
Exams and Tests
Tests may include:
Treatments may include:
- Immune suppressing medicines if the fistula is a result of Crohn disease
- Surgery to remove the fistula and part of the intestines if the fistula is not healing
- Nutrition through a vein while the fistula heals (in some cases)
Some fistulas close on their own after a few weeks to months.
The outlook depends on the person's overall health and how bad the fistula is. People who are otherwise healthy have a very good chance of recovery.
Fistulas may result in malnutrition and dehydration, depending on their location in the intestine. They may also cause skin problems and infection.
When to Contact a Medical Professional
Contact your health care provider if you have:
- Very bad diarrhea or other major change in bowel habits
- Leakage of fluid from an opening on the abdomen or near the anus, particularly if you have recently had abdominal surgery
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Li Y, Zhu W. Pathogenesis of Chron's disease-associated fistula and abscess. In: Shen B, ed. Interventional Inflammatory Bowel Disease. Cambridge, MA: Elsevier Academic Press; 2018:chap 4.
Nussbaum MS, McFadden DW. Gastric, duodenal, and small intestinal fistulas. In: Yeo CJ, ed. Shackleford's Surgery of the Alimentary Tract. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 76.