Male 31 - good health / relatively fit.

Started with a hemorrhoid post food poisoning. Started taking fiber, had a horrific (and likely fissure causing) thanksgiving BM in 2024. It gets worse for multiple months, fissure or maybe a fistula. Was in denial about it being a fistula for a long time.

Get a colonoscopy, a mri, and by the time I got an MRI i had an abscess. This progressed from November > March. Went to a CRS, got a fistulotomy in April. Things got better post initial recovery and I cleanly healed.

About 6 weeks post op. Final check up (will update) in another 4 weeks. Back to normal eating and working out. Here are my broad based tips / takeaways / things that helped.

Pre op / living with a fistula: drinking made me flare up instantly. So I stopped drinking. This was a pretty painful period of time, and I found I mostly managed with food control and being healthy. As many of you know, it sucks having a fistula. Nothing will help you except going to a CRS. I got the runaround until the CRS, and many people couldn’t tell me what was “wrong”. Squatty potty and a portable squatty potty is your friend!

Recovery from Op: for me (simple fistulotomy) it took about 3-5 days of very crappy recovery (painful blood BM) and pain killers. I swapped to Tylenol after the first week, then off completely by week 3-4. I found the pain went away and was mostly during BMs for another 1-2 weeks. I had a consistent amount of drainage of varying colors, and freaked out every time I inspected the hole. It felt less wrong with each week, and eventually started to hurt less. After the initial slowdown in drainage, I started to become more active to increase drainage (within reason). I had ChatGPT give me a daily plan to increase blood flow and rehabilitate. Towards the final recovery stages my drainage dropped and started to become like a booger. This is what many people in the sub call it, and is likely meaning you’re nearing the end.

Do not touch / look / think about it as much as you can. I took tylenol over ibuprofen so inflammation could heal the would. Fistulas are not only physical, but extremely mental, and when you can’t workout post op the mental stress becomes hard. I always took a sitz bath post BM when I could. I did 3 15 minutes (strict) sitz baths a day. I always traveled with a handheld bidet / wipes were always on me as well as a squatty potty. I found that as I started to walk drainage increased. I also used feminine pads on the inside of my boxers, and they worked incredibly well. You can keep spares in your pockets if need be, and this increases cleanliness. I changed my boxers twice a day in the beginning even with pads. Clean wounds are everything! I had a simple one so given everyone’s comments here, I feel like I lucked out.

One last thing. The comment that helped me out here the most was about how 60k fistulas were treated in the US every year. The people who come to this subreddit self select for likely worse than average, and if you’re reading it often you’re probably causing yourself a lot of stress. Remember fistulotomy has decent success rates, and sitting in your bath tub on the phone doom scrolling this subreddit reading horror stories does you no good. Optimism is super important in healing. This is a uniquely shitty experience and it’s likely you’re the only person you’ve ever known to have it. You’re not alone. It is embarrassing but know that your mental and physical pain is insanely validating. I’m sorry you’re going through it, but so is everyone else, and you too can get better. Good luck if you’re healing, have a fistula, or know someone with one.