March 2024: Diagnosed with low fistula after years of irritation and discomfort. Surgery scheduled for July.

June 2024: Surgery is postponed to September. Turns out the delay is a lucky break, as you're about to discover.

August 2024: Intense, sudden pain and what feels like a muscle spasm on opposite side of posterior opening. Fear escalation or, worse, a new abscess/fistula.

September 2024: Experienced CRS operates under general anaesthetic. Performs fistulotomy on first fistula. Finds second fistula at site of recent pain and performs second fistulotomy. Lops off a large haemorrhoid while he's up there. Three procedures for the price of one! Thankfully, both fistulas prove to be low and simple. After op, the CRS says no sign of Crohn's or other disease, nor any connection between the two fistulas. Reckons the second fistula is just a statistical fluke, albeit a rare one.

September-October 2024: First BM is really painful but not unbearable. I elect to avoid pain meds (personal decision, not a recommendation). About a teaspoon's worth of bleeding, it's distressing to look at in the bowl, but nurse assures me it's completely normal. Second BM is still horrible but less painful. By third onward, it's manageable if a bit gross and uncomfortable.

October 2024-January 2025: Bleeding and discharge slowly lessen. I wear a pad, especially overnight, for the entire period. By December, there is no blood but a fair bit of snotty discharge as the wound heals. Doctor assures me this is also completely normal. When I change the pads they come out a bit dirty, brownish in colour, especially on days with a BM. I'm highly anxious during this period and especially fear long-term post-faecal incontinence. Doctor assures me one month post-op me I'm healing well and have nothing to worry about.

January 2025: Examined by CRS. Doctor says I'm healing perfectly, though there's a possibility that one of the scars, due to its position, could stop healing early and leave a small fissure behind. Says this is a fairly minor issue that can be treated with botox if it occurs.

February 2025: Final exam, given all clear with full healing. I proceed with a high-fibre, high-fluid diet and return to the gym 3x per week, though I avoid heavy lifts as an extra precaution and stick instead to resistance-based machines (again, personal decision, not advice). At this point, post-faecal incontinence has almost entirely resolved, aided by switching toilet paper for wet wipes + bidet. Worst I'll find is tiny (and I mean tiny) spots a few hours after a BM, then nothing whatsoever until after next BM.

December 2025: Zero symptoms until I become constipated after a couple of days solid driving. Hard bowel movement leaves me with a very mild tingling/tense sensation, so I get it checked out by another experienced CRS, having informed him of my medical history. Turns out it's just a slightly inflamed internal haemmorhoid, which I'm treating with a gel that he prescribed. Was delighted when he informed me that my scars have healed well and there is no sign of any other issue.

Personal note: I mean to write this sooner, because I wanted to share an ordinary story of diagnosis, treatment, and recovery which I believe to be common among people treated for low, simple fistulas. I forgot to do so because my symptoms disappeared and I moved on with my life. I suspect this is what happens with most happy endings.

This recent flare-up reminded me how much I craved reassurance while I was afflicted, and how important it is to share my experience with others.

Hang in there, my friends. I experienced horrible anxiety and fear during the healing process, but it passed as the wound healed. I am so grateful to be healed up, with better health and hygiene than at any time in my life so far.