A gastrointestinal fistula is an abnormal opening in the stomach or intestines that allows the contents to leak.
- 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
Most gastrointestinal fistulas occur after surgery. Other causes include:
- Blockage in the gastrointestinal tract
- Inflammatory bowel disease (most often Crohn's disease)
- Radiation to the abdomen (most often given as part of cancer treatment)
- Injury such as deep wounds from stabbing or gunshot
Depending on where the leak is, gastrointestinal fistulas may cause diarrhea, malabsorption of nutrients, and dehydration.
- Entero-enteral fistulas may have no symptoms.
- Enterocutaneous fistulas cause intestinal contents to leak through an opening in the skin.
Exams and Tests
- Barium swallow to look for a gastrointestinal fistula
- Barium enema to look for a fistula involving the colon
- CT scan of the abdomen to look for fistulas between loops of the intestines or areas of infection
- Fistulogram, in which contrast dye is injected into the opening of the skin of an enterocutaneous fistula and x-rays are taken
Treatments may include:
- Immune suppressing medicines if the fistula is a result of Crohn's 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
Call 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, especially if you have recently had abdominal surgery
Lichtenstein GR. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 143.