• Tuesday May 26,2020


There are morbid, congenital and artificially created fistulas. A fistula is always a passageway that serves for the flow of fluid. It often forms in inflammation to drain pus. A pathological fistula usually needs to be treated surgically.

What is a fistula?

Morbid fistulas are common in the anal area of ​​the intestinal disease Crohn's disease. The cause of the pathological fistula is a purulent inflammation that is usually triggered by bacteria.

A fistula is a tubular connection between two hollow organs or between a cavity in the body and the body surface. There are different types of fistulas. The artificial fistula, such as the nutrition fistula, is surgically applied to bypass a portion of the digestive tract and to feed the body with food.

The congenital fistula is caused by prenatal (prenatal) developmental disorders. There are connections that should actually close before birth. In the urachal fistula (bladder-navel fistula) remains a connection between the bladder and the navel, in the preauricular fistula on the ear, gill ducts have not closed.

The pathological fistula develops in inflammatory processes either when an abscess (encapsulated pus accumulation) has formed or when a purulent inflammation has developed in an existing body cavity. Morbid fistulas are common in tooth inflammation in the mouth and in the anal area in the intestinal disease Crohn's disease.


The cause of the pathological fistula is a purulent inflammation that is usually triggered by bacteria. It develops pus in a closed body cavity or it forms due to the inflammation a newly formed closed tissue cavity (abscess).

Pus is a product that arises in the defense reaction against germs. Since the pus can not drain and the pressure from the pus production increases, the body forms a tubular duct to drain the secretion.

The fistula either goes to a cavity in the body or to the body surface. There it becomes visible as a small hole from which pus emerges. The cause of a congenital fistula is a disorder in prenatal development.

Diseases with this symptom

  • Arteriovenöse_Fistel
  • Crohn's disease
  • anal fistula

Diagnosis & History

A fistula, which runs to the body surface, usually shows up as a small pimple filled with pus. Those affected feel pain and a feeling of pressure at the site of the inflammation. The tissue over the site of inflammation is swollen and the pain radiates into the environment.

Sometimes the skin itches over the fistula. Anal fistulas make themselves felt at first only by wetness. The more secretions accumulate, the more clearly the pressure and swelling are noticeable. Most of the time a part of the pus is emptied when you press on the swelling. But after some time, the fistula, or the underlying abscess fills again.

Internal fistulas, ie pathologies between two organs, often cause fever and fatigue. The doctor will recognize by the symptoms that there may be a fistula. However, other diseases with similar symptoms, such as boils, must always be excluded. With the help of ultrasound or X-ray further information can be obtained. To do this, the doctor fills the fistula with a contrast agent to visualize its course.

When should you go to the doctor?

A morbid fistula forms in inflammation, so that the resulting fluid, generally pus, can drain. The fistula is a tubular connection located either between two hollow organs or otherwise between a body cavity and the body surface. In addition to the pathological fistula, there is still the congenital fistula and an artificial fistula. This section is about the urgent need for a doctor to treat the pathological fistula.

The cause of the formation of a fistula is often the purulent inflammation of a naturally existing body cavity. In addition, abscesses can lead to the formation of a fistula and inflammation of the teeth and intestinal diseases such as Crohn's disease. The fistula underlying purulent inflammation are primarily triggered by bacteria. Pus always presents a potential risk to the body. Therefore, a fistula definitely needs medical treatment.

Since medical laymen often can not recognize the symptoms of a fistula, it should be said here that a doctor should be consulted, even in the case of seemingly mundane discomfort. A fistula with a connection to the body surface is often expressed as an apparent purulent pimple at first. Itching or wetting may also indicate a fistula. At the latest when exhausted or fever it is urgently time for the walk to the doctor. The fistula therapy is varied.

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Treatment & Therapy

In order to eliminate a fistula, surgery is usually required. For fistulas formed by abscesses or inflamed hollow organs, the inflammations are treated with antibiotics. Abscesses must be surgically opened and emptied. Larger abscesses remain open for some time, that is, you put a drainage (drain hose) to the body surface, so that any newly formed pus and wound water can drain.

Sometimes, an antibiotic-soaked tamponade is placed in the abscess to speed healing. This will be removed after one or two days. When the inflammation has healed, the fistula returns on its own. In the anal fistula a thread drainage is placed in the fistula. This often has to stay for weeks to months, so that the fistula gradually dry out and heal.

In congenital fistulas, the treatment depends on the symptoms that cause it. A bladder-navel fistula must be surgically closed, as urine escapes from the navel. In contrast, a congenital ear fistula often remains without any discomfort and usually does not need to be treated.

Outlook & Forecast

In most cases, surgery is necessary to remove the fistula. As a rule, there are no further compilations or complaints, so that the overall result is a positive course of the disease.

Often the fistulas are filled with pus and can burst. In the case of unhygienic treatment, this can lead to inflammations and infections. Very uncomfortable for the patient are fistulas in the anal area. These often itch and swell, so that the quality of life of the affected person is greatly reduced. Most patients also suffer from fever and a general malaise. If the fistula occurs, a doctor must be consulted. Treatment with home remedies is not recommended.

Treatment by the doctor usually takes place with the help of antibiotics and leads relatively quickly to success. In case of abscesses these are emptied. After the healing of the inflammation, the fistulas usually go back by themselves, so that there are no further complaints for the patient. If the fistula is already innate, then usually no treatment is necessary. This also applies to congenital fistulas in the area of ​​the ear.


You can prevent a fistula that results from inflammation by treating the inflammation early. It prevents the formation of pus and thus prevents the formation of a fistula.

You can do that yourself

As a rule, a fistula has to be surgically removed. However, numerous options are available to prevent a fistula or to relieve the symptoms. Extremely important is a balanced diet. Those affected should abstain from spicy foods, ready meals and fatty meals. The diet should be supplemented with fiber and cereals. They soften the bowel movement and facilitate defecation.

To prevent a fistula, sufferers should drink plenty of water. The recommended amount is about two liters daily. Alcohol and soda should be avoided. Alternatively, fruit juices are excellent. They help to prevent blockages that put heavy pressure on the fistula. Moreover, the use of a pillow is advisable. Especially for sufferers who have to sit for many hours, a pillow is ideal. This helps to avoid heavy pressure on the back, buttocks and legs. In addition, absorbent pads are useful. Thus, sufferers do not have to worry about blood, pus and wound secretion stains. Alternatively, diapers can also be used. These are however thicker and stigmatized.

Of great importance is personal hygiene. Patients should clean themselves after each visit to the bathroom. It is important to avoid bacteria that stay on the skin. This is the only way to avoid infection. On the way, sufferers can temporarily use wet wipes.

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