Gastrointestinal Fistulas

Overview and Facts about Gastrointestinal Fistulas

A gastrointestinal fistula is an abnormal opening in your stomach or intestines that allows gastric fluids to leak out to other parts of the intestine, skin, or other organs. Depending on where the fluids leak, you might develop an infection that puts your digestive health at risk.

There are a few different kinds of gastrointestinal fistulas. They include:

• Complex fistula, which involves multiple organs
• External fistula, also known as a cutaneous fistula, in which fluid seeps into the skin
• Intestinal fistula, when fluid leaks into other parts of the intestine
• Extraintestinal fistula, when fluid leaks into another organ

Signs and Symptoms of Gastrointestinal Fistulas

Symptoms vary depending on the type of fistula you have. For an external fistula, you might experience:

• High white blood cell count
• Pain in your belly
• Bowel obstruction
• Fever

Internal fistulas cause a slightly different array of symptoms:

• Dehydration
• Bleeding from the rectum
• Diarrhea
• Sepsis
• Not absorbing nutrients from food
• Weight loss

Causes and Risk Factors of Gastrointestinal Fistulas

Gastrointestinal fistulas most commonly occur after intra-abdominal surgery. Experts estimate that this is the cause in 85 to 90% of cases. However, other causes include:

• Tumors or cancers
• Blockages or obstructions in the intestine
• Crohn’s disease
• Infections or abscesses
• Radiation to the abdomen

Tests and Diagnosis of Gastrointestinal Fistulas

Before conducting any imaging tests, your doctor will perform a blood test to determine your nutritional status and serum electrolytes. Abnormalities in the results might point to a gastrointestinal fistula.

Confirming the diagnosis requires imaging tests. These might include:

• Upper and lower endoscopy, when the doctor inserts a tube with a camera into your gastrointestinal tract to get a closer look
• Upper and lower intestinal X-ray paired with a barium swallow or barium enema, which helps your intestines stand out more in the image
• Fistulogram, which involves injecting a colored dye into the skin and taking an X-ray

Treatment and Care for Gastrointestinal Fistulas

In many cases, fistulas can close on their own. Your doctor will try to measure the gastric fluid output of the fistula to see whether it’s likely to seal up naturally. If the fistula doesn’t heal, you might need surgery to remove it.

However, before your doctor takes such a drastic step, they will try other treatments. These include keeping you hydrated, prescribing antibiotics to control infection, and providing nutritional fluids if your body doesn’t absorb enough on its own.

Overall, it might take several weeks or months for a fistula to heal completely.