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Liver Transplant: An Overview

A liver transplant is a surgical procedure in which doctors remove a diseased liver and replace it with a healthy one. This may involve replacing the entire liver or just a section of it. Here’s what you need to know about this procedure.

When is a liver transplant pursued?

A liver transplant is often the best option for people with uncontrollable liver failure. In most cases, liver failure in adults is caused by a chronic condition. For instance, cirrhosis is one factor that leads to liver failure over time. Hepatitis B, hepatitis C, alcoholic liver disease, cancer, and some genetic diseases can also cause liver failure in adults. Children sometimes need a liver transplant as well, often due to genetic disorders or diseases affecting the bile ducts or liver.

Before the procedure

Leading up to a liver transplant, doctors assess your condition with rigorous testing to see the severity of your liver failure and whether you should get a liver transplant. This includes blood testing, diagnostic testing, a psychological evaluation, and more. All of these factors go into whether you may be placed onto the national liver transplant waiting list. Some reasons people are not able to get a transplant include having a chronic untreatable condition, having metastatic cancer, drinking too much, and having severe heart issues.

If you are able to get a transplant, you’ll be placed on the waiting list. People who need a transplant most urgently are at the top of the list, and people with a less urgent need are further down the list. Your place on this list is determined with a structured scoring system called the Model for End-Stage Liver Disease (for children under 12, the Pediatric End-Stage Liver Disease (PELD) is used instead).

If you are preparing for a transplant, your doctor will discuss the steps you need to follow before the procedure. These steps can include avoiding eating and drinking 8 hours before the surgery. If you are receiving a transplant from a living donor, your surgery will be scheduled out in advance. However, if you are receiving a transplant from a deceased donor, you may be called to the hospital for an immediate procedure.

During the procedure

During a liver transplant, doctors sedate you and make an abominable incision while monitoring your vital signs. They remove the diseased liver (or portion of liver) from your body and replace it with the healthy donated liver. They work to connect your blood vessels and bile ducts to the new liver. This is a long process and can take up to 12 hours depending on your situation.

After the procedure

Following a liver transplant, you will spend a few days in intensive care until your condition is stabilized. During this time, doctors will monitor your condition to ensure the transplant has gone well. You will likely be on a ventilator to help you breathe initially. You may also receive IV drips, antibiotics, and anti-rejection medications to help fight against your body’s immune response to your new liver. After you have stabilized, you may spend a week or two more in the hospital in a general non-intensive care room to recover.

Once you have returned home, you will need to follow your doctor’s instructions on keeping your surgical area clean. You should report any symptoms like jaundice, fever, bleeding, or redness around the incision site.

You will also need to take anti-rejection medication indefinitely following the transplant. This involves taking immunosuppressants that weaken your immune response so that your body doesn’t reject your new liver. This puts you at a higher risk of infections, and can also increase your blood pressure and put you at risk for diabetes. Fortunately, over time you will be able to take less medication as your body adjusts. You should consult with your doctor closely to follow the best plan.

Our experienced team at GHP has years of experience treating patients with liver conditions. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

What is the low FODMAP diet?

The low FODMAP diet is a temporary diet designed to help people with IBS (irritable bowel syndrome). In this diet, you tactically remove FODMAP foods to eliminate IBS symptoms, and then slowly add them back in to identify which cause you issues. You can think of it as a short diet that will help identify problem foods to avoid long-term. Today on the blog, we’ll go into detail on the FODMAP diet and how it can help you.

What is FODMAP?

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Basically, these are all short-chain carbohydrates (sugars) that you can find in foods. The small intestine may absorb these poorly, causing stress on the digestive system. Many people with IBS are sensitive to some of these sugars, and can experience symptoms like bloating, diarrhea, and cramping if they eat them. This diet is designed to remove foods that contain the sugars to help relieve symptoms first.

Phase 1 of a FODMAP Diet

In the first phase of this diet, you’ll avoid eating certain foods. The foods you remove in a FODMAP diet include milk, honey, fruits, beans, sweeteners, and more. Your medical provider will provide specific guidelines to follow. For this phase, you’ll need to avoid FODMAP foods for 4-6 weeks. This may help eliminate symptoms you’ve had from the foods. For people with a bacterial overgrowth issue in their small intestine, it gives time for the bacteria levels to decrease.

The diet does eliminate a lot of foods you may be used to eating. Some foods you can continue to eat in this phase of the diet include eggs, meat, certain cheeses (like brie), potatoes, grapes, and almond milk.

Phase 2

Phase 2 involves slowly reintroducing certain foods. While Phase 1 is all about eliminating everything and calming down symptoms, Phase 2 is an exploration of what specific foods you react to. The way this usually works is by adding one FODMAP food back into your diet every few days. This gives you time to see if the latest food you added causes any reaction. When you encounter a reaction from a specific food, you will be able to avoid that food long-term with this knowledge.

Effectiveness

The FODMAP diet approach is considered one of the most effective therapies for treating IBS. It reduces symptoms in around 86% of people. However, since it is so restrictive initially, you will need to work with a doctor or dietitian who can coach you on staying healthy while avoiding FODMAP foods. They can provide a full list of FODMAP foods, and provide key guidance while you undergo this therapy. When successful, the long-term dietary changes you make as a result of FODMAP dieting are a powerful tool to reduce IBS and bacterial overgrowth symptoms.

Our experienced team at GHP has years of experience treating for IBS. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Colon Cancer Stories

Colon cancer touches many lives each year. It can be powerful to learn how other people have experienced screenings, a diagnosis, and fighting the disease. To wrap up our blog posts on colon cancer for this awareness month, we’re going to showcase a few stories from several sources today.

Colon Cancer Foundation: Jamie’s Story

The Colon Cancer Foundation (CCF) has compiled a number of patient stories about colon cancer. One story features Jamie Crespo, who had both parents diagnosed with colon cancer in the same year (2017). Jamie details how the diagnoses came as a surprise due to a lack of immediate family history of the disease, and how it changed everyone’s lives. She also talks about her parents’ recovery, what she’s learned, and how she has made lifestyle changes following the experience. Read Jamie’s story and others on the CCF’s website.

Colon Cancer Coalition: Melissa’s Story

The Colon Cancer Coalition (CCC) also has a huge number of patient stories you can peruse. One is from Melissa Marshall, who was got colorectal cancer at the age of 51. She had been ignoring symptoms for a while before her diagnosis, including rectal bleeding, weight loss, and fatigue. Melissa eventually met with a colorectal surgeon who performed a colonoscopy and found a tumor in her sphincter. She was diagnosed with Stage III colorectal cancer, and went on to receive chemotherapy and an ostomy bag. Today, Melissa is cancer-free and is a strong advocate. She has also formed a non-profit dedicated to educate people about colorectal cancer. You can read Melissa’s story along with many others here.

Colon Cancer Prevention Project: Lindsay’s Story

The Colon Cancer Prevention Project has featured a striking story from Lindsay Norris, an Oncology nurse who survived Stage III colorectal cancer. She talks about how she never truly understood how her patients felt until she experienced colorectal cancer. In a lengthly blog post, Lindsay goes through all of the elements of her diagnosis and experience receiving treatment, comparing how she viewed these things as a nurse versus how she experienced them personally. It’s a highly insightful read- you can read the post here or visit her website.

Celebrity Colon Cancer Stories: Chadwick Boseman and Will Smith

Colon cancer has affected several well-known celebrities. Just in the past year, Chadwick Boseman passed away with colorectal cancer. The actor, known for films like Black Panther and Thurgood, was only 43. He had been fighting colon cancer for four years. We wrote a blog back in November of 2020 about Chadwick’s life and battle with colon cancer. You can read that post here.

Another story we recently featured is about actor Will Smith. Back in 2019, Will documented the process of his colonoscopy screening. In a vlog posted to his YouTube channel, he shows conversations with his doctor, the prep process, the day of the screening, and the follow-up. It’s a great video that showcases what the experience of getting a colonoscopy is like, and it also drives home the importance of screenings. Read our blog post on the video here.

Our experienced team at GHP has years of experience screening for colorectal cancer. We can help establish the best plan of care for your situation. Read more about how we perform screenings here. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

ValueOfColonoscopy.org: ASGE’s Useful Awareness and Screening Tool

There are a lot of great resources if you are interested in learning more about colon cancer and screenings. One of our favorites comes from the American Society of Gastrointestinal Endoscoy (ASGE). The ASGE has a plethora of resources including videos, a screening tool, and statistics at ValueOfColonoscopy.org. Today on the blog, we’ll take you through some of the useful resources on the website.

Screening Tool: Determining Which Test You Should Get

One question many people have about screenings is which test to get. There are numerous options available. It can be confusing when figuring out which is the best fit. Fortunately, the ASGE created a tool that helps you identify the screening method that’s right for you. In a simple yet informative document, they take you through your options based on your risk level (no personal or family history of colon polyps or cancer, family history, or personal history). This tool shows you how these factors impact when you should be screened, how often, and with which screening method. For example, if you have a family history of colon cancer or polyps, it shows that you should have a screening as early as age 40. It also shows that a colonoscopy is best screening given your family history. It recommends talking with your doctor to establish a plan.

Colonoscopies during the Pandemic

During the pandemic, many people have had valid concerns about the safety of activities like doctor’s visits. This has actually impacted how many colonoscopies doctors have performed, and as a result an increase in the number of missed colorectal cancer diagnoses (read our blog post here to learn more). In a video, the ASGE shows how many steps medical professionals are taking to ensure your safety during screenings. They talk about pre-arrival screenings, in-office distancing and barriers, masking, PPE, testing, staff vaccinations, and more. We highly recommend watching this video to get a clear picture of how safe your screening will be. Plus, read our blog post here about what we have been doing at GHP to keep you safe.

Tips as you Prepare for a Colonoscopy

Another important thing this website covers is common patient FAQs leading up to a colonoscopy. The ASGE has a number of helpful guides and tips for you as you prepare for a screening. For example, they have a webpage dedicated to understanding bowel prep, an aspect of screening that many patients dread. They discuss the importance of bowel prep, what type of prep you may need to pursue, and other helpful tips. They even discuss common side effects, specific steps in prepping, and what to do if you forget to take prep medication. This is a great resource to help you make sure your screening is as effective as possible. The ASGE also has content and FAQs that help you understand colon polyps and colonoscopies.

Our experienced team at GHP has years of experience screening for colorectal cancer. We can help establish the best plan of care for your situation. Read more about how we perform screenings here. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Colon Cancer Awareness: Our Favorite Online Resources

March is colon cancer awareness month. This disease is preventable with timely and regular screenings. Awareness-raising resources and campaigns are a key part in increasing screening rates, so today on the blog we’ll share some of our favorite online resources on the topic.

CDC Resource Library

The Centers for Disease Control and Prevention has an excellent website full of resources. Among these resources is all of their colon cancer content. They have everything from personal stories to an awareness quiz and posts to share on social media. Here’s a list of some of our favorite resources they offer:

  • Data visualizations tool
    • You can examine colon cancer statistics with tools including an interactive map, tables, and charts.
  • Basic information
    • The CDC provides a central hub for all of the basics about colorectal cancer, including symptoms of the disease, screening information, and questions you can ask your doctor.
  • Screening stories
    • Read stories from people who have gotten screenings and learn about their experiences.

ASGE Colon Cancer Awareness Resources

The American Society for Gastrointestinal Endoscopy has a number of great resources you can use as a patient and as an advocate. Here are a few highlights from their website:

  • Tool to start dialogue about screening for patients and doctors
    • This document breaks down the different types of screening available, divided by different risk categories.
  • Videos
    • ASGE has a number of videos that cover topics like colonoscopies, myths about colon cancer, and community outreach.
  • Banner and poster
    • The organization provides a banner you can use on your website or email signature, plus a poster you can print and hang up.

ASCRS’ Resources

The American Society of Colon & Rectal Surgeons has several resources on their website that you might find helpful. Here are a few favorites:

  • Media pitch letter
    • ASCRS has a letter that you can modify and send to local news organizations, asking for air time to talk about colon cancer.
  • Online store
    • The organization has an online store where you can purchase brochures in bulk for use in treatment settings.

Colon Cancer Coalition’s Targeted Campaign

The Colon Cancer Coalition has a targeted awareness campaign called #BlueForCRC that you can participate in. Their website has resources for this campaign including:

  • Sample social media posts
  • A training webinar for advocates
  • Informational resources that can be distributed
  • Tips and tricks for successful advocacy using their campaign

ACG’s Website

The American College of Gastroenterology’s website features resources that you can use for awareness-raising. Some of our favorites are:

  • A library of graphics that you can print for patients, hang as posters, and share on social media.
  • A podcast series that addresses colon cancer topics in a Q&A format. Episodes cover topics including risk factors, screenings, bowel prep, and early detection.

Our team at GHP has years of experience screening for colorectal cancer. We can help establish the best plan of care for you. Read more about how we perform screenings here. Contact any of our office locations to learn about the options we offer and book an appointment today.

How has the Pandemic Affected Colonoscopies?

The coronavirus pandemic has impacted our lives in countless ways. From finances to health and other aspects of life, it has changed how we live each day. In particular, many common medical check-ups, screenings, and elective procedures have been put on hold or delayed. One of these, the colonoscopy, has seen significantly decreased rates during the pandemic. This is a serious issue, as we know colonoscopies are a key screening strategy to prevent colorectal cancer. On today’s blog, we’ll take a look at how the pandemic has affected colonoscopies.

Colonoscopies During the Pandemic

Early on in the pandemic in 2020, medical practices put many elective and non-essential medical visits and procedures on hold. As a result, screenings for cancer like colonoscopies dropped significantly. One study examining screening rates in the San Francisco area found that colonoscopies decreased about 90% from February to May 2020. This coincided with an 85% decrease in fecal immunochemical testing (FIT), another screening method in the same time frame. There was also a 70% decrease in all in-person appointments, and a 60% increase in telehealth visits. Another report estimated that if that trend continued through early June 2020, there could be around 19,000 missed colorectal cancer diagnoses and over 4,000 additional colorectal cancer deaths across the United States.

These are significant impacts, and compound existing inequities in health outcomes. Many groups that have an increased risk of colorectal cancer have also experienced a higher risk of death from the coronavirus. These groups include Black, Native American, and Hispanic people.

Clearly, the pandemic has caused cascading public health problems. Fortunately, as we have learned more about the coronavirus, medical practices have been able to respond to transmission threats to practice safely. Masking, social distancing, sanitizing, and now vaccinations for medical staff have helped to create safe spaces for patients to receive medical care.

Importance of Screening for Colorectal Cancer

Screening for colorectal cancer is extremely important. When properly done, it has a high success rate at cancer prevention. With a colonoscopy, doctors can identify and remove precancerous polyps that could otherwise develop into cancer over time. The colonoscopy is the gold standard for screenings. When patients get colonoscopies on a proper schedule, the incidence of colorectal cancer falls by around 90%.

Gastro Health Partners, in line with various other organizations, is now endorsing regular screenings starting at age 45. Previously, 50 was the standard for beginning screenings. By changing this to 45, we can prevent more potential cases of cancer and save lives. If you are close to 45 or older, talk with your doctor about getting screened. They will take your situation into account and may recommend earlier or more frequent screenings depending on factors like family history and personal history of polyps.

Our experienced team at GHP has years of experience screening for colorectal cancer. We can help establish the best plan of care for your situation. Read more about how we perform screenings here. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Gastroparesis: A Summary of the Condition

Gastroparesis is a condition in which the stomach is unable to empty normally. Read along for an overview of the disease. 

Causes and Risk Factors

Gastroparesis is usually caused by a nerve injury of some sort. When the vagus nerve, the nerve controlling stomach muscles, becomes damaged it can stop working properly. When the nerve functions properly, it contracts the muscles in the stomach to help food move through your digestive tract. If the nerve is damaged, food can sit in your stomach longer than normal. 

The root cause of this nerve damage can vary. Some viral infections can be at the root of the issue. In other cases, it may be a side effect of surgery on the stomach or nerve. Narcotic pain medications can also slow the rate the stomach empties. 

There are a few risk factors that increase your chance of developing gastroparesis. People with type 1 or 2 diabetes are at a heightened risk. Additionally, people with nervous system diseases like Parkinson’s or MS are at an increased risk. 

Symptoms of Gastroparesis

This condition is characterized by a number of potential symptoms, which can vary by person. Vomiting, nausea, heartburn, and GERD are symptoms many people with the condition experience. Abdominal pain and bloating are also symptoms in some cases. You may feel full after eating very little and lose weight with the condition as well. You may also become malnourished and dehydrated due to the condition.

Diagnosis

Doctors can diagnose gastroparesis with a number of tests. They may want to see how quickly your stomach empties. To do this, they can use a technique called scintigraphy in which they have you eat a light meal with a small amount of radioactive material in it. They place a scanner on your abdomen that tracks the material and the rate that food is passing through your stomach.Another test they can utilize is an upper endoscopy. Here, they use a long tube with a camera on the end to visualize your upper GI system. This can also help diagnose other conditions with similar symptoms. 

Treatment

Gastroparesis is often a chronic condition. As such, your doctor will focus on treating symptoms and identifying the underlying cause. If you are diabetic, you should focus on controlling your blood sugar levels, as this can reduce gastroparesis issues. Dietary changes are crucial as well. You should work with a dietitian to identify foods and habits that lend themselves to easy digestion. You can also eat smaller, more frequent meals and chew food thoroughly. In some cases, medication can also help stimulate the stomach muscles and control nausea. Follow your doctor’s advice for any prescriptions. 

Our experienced team at GHP has years of experience treating gastroparesis. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

What are Gallstones?

Gallstones are hard deposits that can form in your gallbladder. Here’s what you need to know about the condition. 

Causes

Gallstones are mostly made up of cholesterol (around 80%) and bilirubin and calcium salts (around 20%). Doctors believe that cholesterol may be tied to the root cause of gallstones. The gallbladder stores bile, a fluid that helps dissolve fats. If your liver produces more cholesterol than your bile can handle, hardened crystals can form and eventually turn into hard deposits (gallstones). The previously mentioned chemical bilirubin may cause gallstones as well. Your body produces bilirubin to break down red blood cells. If your liver produces too much bilirubin (due to conditions like blood disorders and liver cirrhosis), excess bilirubin can lead to gallstones. One last potential cause of is a slow-draining gallbladder. If bile does not exit your gallbladder correctly, it can become concentrated.

Risk Factors

There are a few significant risk factors for gallstones. Some of these are lifestyle factors. These lifestyle risk factors include being obese or overweight, rapidly losing weight in a short timeframe, and eating a high fat or cholesterol diet with low fiber intake. Additionally, people over 60, women, Native American and Mexican people, and people with a family history of gallstones are at a higher risk. Last, there are some relevant medical risk factors. These include being pregnant, having cirrhosis, taking cholesterol-lowering medication, and taking medication with high estrogen content. 

Symptoms of Gallstones

Gallstones commonly cause several symptoms. If a gallstone becomes stuck in a duct and blocks it, this can cause symptoms. One of the first may be a sudden onset of intensifying pain in your upper right abdomen. This pain could also occur in the center of your abdomen. You may experience back pain between your shoulder blades, pain in your right shoulder, and nausea and vomiting as well. These symptoms can last minutes or hours. Serious complications can occur, and are indicated by symptoms like yellowing skin and eye whites, a high fever, and tea-colored urine. Seek medical attention immediately if you experience these symptoms. 

In some cases, you may not have pain at all. In fact, some experts estimate around 80% of people with this condition have no symptoms. 

Diagnosis

Doctors diagnose gallstones in a few ways depending on your situation. If you see them due to any of the above symptoms, they may start with a physical exam to check for signs of jaundice. There are a few diagnostic tests they can perform as well. Often, they will order an ultrasound to visualize your abdominal area and identify signs of gallstones. They may also perform an endoscopic ultrasound (EUS) if they think they could have missed any smaller gallstones with an ultrasound. Another procedure they may perform is an Endoscopic Retrograde Cholangiopancreatogram (ERCP), which can also help identify gallstones. They can also order a blood test to see if your bilirubin levels are abnormal. 

In many cases, your doctor may identify gallstones incidentally while performing one of the above procedures for another purpose . This is particularly true if you have asymptomatic ones. As mentioned before, most people with do not have symptoms, so this is a fairly common way they may diagnose your gallstones. 

Treatment

Often times, you may not need any specific treatment for gallstones (especially if they cause no symptoms). You may be able to pass them without any pain. If you are experiencing any of the more serious symptoms discussed previously, you may need surgery. Doctors can perform a procedure called a cholecystectomy, in which they remove your gallbladder. This prevents gallstone recurrence. Your gallbladder is not essential, so removing it does not cause major issues. If surgery would be risky for you, your doctor may prescribe medication to dissolve your gallstones. In this case, you will likely have to continue medication use for a long period of time.

Our experienced team at GHP has years of experience treating gallstones. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Coronavirus Vaccines: Best Practices for People with IBD

People with Inflammatory Bowel Disease (IBD), such as Crohn’s and Ulcerative Colitis, may have questions about how they should approach coronavirus vaccines. The International Organization for the Study of Inflammatory Bowel Disease (IOIBD) recently highlighted an article titled ‘SARS-CoV-2 vaccination for patients with inflammatory bowel diseases: recommendations from an international consensus meeting.’ In this article, the organization highlights the recommendations related to coronavirus vaccines IOIBD has developed for people with IBD. Here are a few highlights:

1. People with IBD should get a coronavirus vaccine

Overall, there was broad and overwhelming agreement among IOIBD members that coronavirus vaccines are safe and necessary for people with IBD. This consensus was reached through multiple questions that explored IOIBD member opinions on the efficacy and safety of the vaccines for IBD patients.

2. People with IBD should get a coronavirus vaccine as soon as it is possible

Not only does the IOIBD recommend vaccines for people with IBD, they recommend people with IBD receive a vaccination as soon as they are eligible.

3. Coronavirus vaccines, including messenger RNA vaccines, replication-incompetent vector vaccines, inactivated vaccines and recombinant vaccines, are safe for people with IBD

IOIBD members considered the main types of vaccines that may be available for people with IBD. They did this to ensure safety across all vaccines. After review, they broadly agreed that all vaccine types are safe.

4. Coronavirus vaccination shouldn’t be delayed if a person with IBD is receiving immune-modifying therapies

Some people with IBD may be undergoing immune-modifying therapy to suppress an inflammatory response. Still, coronavirus vaccines are safe for them.

5. People with IBD who receive a coronavirus vaccine should be informed that the vaccine’s efficacy can decrease if they are receiving systemic corticosteroids

This is also an important insight for people with IBD. They should receive a coronavirus vaccine when possible. However, if they are receiving corticosteroids to calm a flare-up, the vaccine may be less effective.

Our experienced team at Gastro Health Partners continues to safely provide care for our patients during the coronavirus pandemic. We can help establish the best plan of care for your situation. Visit us online at https://www.gastrohealthpartners.com/ to learn about the options we offer and schedule an appointment today.

Anal Fistulas: A Brief Overview

Anal fistulas are tube-like passages that connect an infected anal gland to the outside of the skin near the anus. They do not usually heal on their own, and often require surgery. Here’s what you need to know about the condition.

Causes

Typically, anal fistulas originate from an anal abcess. Anal abcesses are collections of pus. These can form when anal glands become infected. Then, a tunnel can form from the abscess to an opening on the skin. This tunnel is an anal fistula. Other less common causes include Crohn’s disease, cancer, trauma, and diverticulitis.

Symptoms of Anal Fistulas

Anal fistulas typically cause a few symptoms. These include pain and swelling around the anus and painful bowel movements. There is often drainage from an opening around the anus, and pain may decrease after drainage. The drainage may be pus and be bloody or foul-smelling. You may also experience fatigue, fever, and chills. Any of these symptoms are good cause to see a doctor.

Diagnosis

Doctors diagnose anal fistulas by first performing a physical exam to identify an opening or boil on the skin near the anus. If there is no visible opening, they may need to perform an anoscopy, MRI, or ultrasound to visualize the fistula tract and determine the severity and size of the fistula.

Treatment

If you have an anal fistula, you will need surgery. Anorectal surgeons will evaluate your fistula to determine how the fistula is affecting your anal sphincter muscle and then minimize the surgery’s effect on anal function. A procedure called a fistulotomy allows doctors to open the fistula tunnel and allow it to heal. Doctors usually prefer this approach if a small amount of the anal sphincter muscle is involved with the fistula. If a significant amount of the muscle is involved, another viable approach is placing a band called a seton through the fistula to promote drainage. The seton stays in place for at least 6 weeks. There is typically a follow-up procedure in this case to get rid of the fistula. Another common surgical technique is the advancement flap procedure. This, like the seton approach, is also useful if a large amount of the sphincter muscle is involved. Here, surgeons cut or scrape out the fistula and then cover the hole where it enters the bowel with a flap of skin from the rectum.

Prognosis and Disease Management After Surgery

Unfortunately, some fistulas may require several surgeries to eliminate them. Following surgeries, you may need to take stool softeners and soak the affected area in a warm bath. Plus, to help with pain, your doctor may inject a local anaesthetic and prescribe pain pills for a short time. The good news is that when properly treated, fistulas rarely come back.

Our experienced team at GHP has years of experience treating anal fistulas. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.