Can fistulas heal on their own with no meds?

I have had a perianal fistula since october, fortunately there has been no drainage or anything like that coming from it, just an uncomfortable hole.
I had an mri in january to see the extent of the fistula. the opening of the fistula had doubled in size about a month ago so i chased up my mri results which i got last week
I was presuming that it was just a shallow fistula which would need antibiotics due to the long waiting time from my mri til the results,
turns out i have a collection of fistulae inside and I have to go on imuran and antiobiotics (i have had the blood tests for imuran including TPMT - i am currently on 8 pentasa a day)
I am also waiting for a call from my consultant who says she needs a meeting with the radioologists and surgeons to see if i need surgery on the fistulae
right so heres the weird part... i have had this hole since october and i know it was still there last thursday as i checked i before i went to the hospital to see the consultant...
i checked it today and the hole has healed over? as in it has a layer of skin over it. i know the channel is still there as i can see it and the layer of skin is not solid underneath
but is this normal? does this mean it is healing?? and if so does that mean i may have avoided surgery? I have taken no medication for the fistula not even any antibiotics yet as i am waiting for a call off the consultant
Seems a bit of a coincidence that when i get told i might need surgery the fistula has grown over??
As far as i was aware fistulas don't heal on their own they need at least antibiotics

*Forgot to mention I also feel a lot better (less lethargic, less d and I have put on half a stone)

Unfortunately they often heal over on the outside, then build up fluid on the inside and erupt again.

I have a lot of "communicating fistulae" running along perpendicular to my anus. My doctor is not treating it because it doesn't seem to bother me.

I wish MRI's weren't so expensive so I could try some meds, then check their status and back and forth until they found something that works. I don't like the thought of them growing until they bother me.

oh dear! i thought i'd got lucky then! maybe still have to have surgery after all

Mish, are you on antibiotics or remicade for your fistulas?

Yeah, unfortunately they often heal over but then they might just branch elsewhere or need to be drained again, instead of healing internally. Since you said you have a collection of fistulae, it sounds like you probably need surgery.

I only had one, which I had surgery for back at the end of last May. I've been on Imuran and Remicade for it, then switched to Imuran and Humira (I was very allergic to Remicade, it turns out), though they're both good for treating fistulae. When they do the surgery, they often insert a seton to allow it to stay open and drain. You can choose to eventually remove it or keep it. I'm getting mine removed at the end of the month to see if it will close up and heal since it's not draining anymore.

Going back to your original question in the thread, though: my father also had a fistula when he was younger, and got surgery for it as well. His eventually closed even without medication, which is lucky.

Thank you TheOcean,
I thought it was too good to be true! the thought of surgery terrifies me haahaa but i guess i'll have to stop being a wimp and get on with it luckily my follow up appointment is after my last exam so looks like it wont interfere with my masters

Surgery used to scare me, too! But by the time I finally got help for my fistula I was in so much pain and I think I was so enthusiastic about being put under (and no longer in pain) that it even stopped scaring me. Terrible motivator to get the surgery over with, but true.

x0lou0x said:

Mish, are you on antibiotics or remicade for your fistulas?

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I was on remicade but built up immunity. Remicade was AWESOME at clearing fistulas, I believe these developed while on Humira.

Antibiotics have never worked for my fistulas. I've tried many.

theOcean said:

Yeah, unfortunately they often heal over but then they might just branch elsewhere or need to be drained again, instead of healing internally. Since you said you have a collection of fistulae, it sounds like you probably need surgery.

I only had one, which I had surgery for back at the end of last May. I've been on Imuran and Remicade for it, then switched to Imuran and Humira (I was very allergic to Remicade, it turns out), though they're both good for treating fistulae. When they do the surgery, they often insert a seton to allow it to stay open and drain. You can choose to eventually remove it or keep it. I'm getting mine removed at the end of the month to see if it will close up and heal since it's not draining anymore.

Going back to your original question in the thread, though: my father also had a fistula when he was younger, and got surgery for it as well. His eventually closed even without medication, which is lucky.

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I am pretty sure that they are finding out that Humira isn't that great for fistulas. It is good for some people for actual Crohn's relief which probably helps some with fistulas. I didn't have too many Crohn's issues on Asacol so we stopped the Humira once the fistula's were seen in the MRI results since it wasn't doing me any good.

As a side note, Humira was causing depression for me after being on it a couple of years.

mish2575 said:

I am pretty sure that they are finding out that Humira isn't that great for fistulas. It is good for some people for actual Crohn's relief which probably helps some with fistulas. I didn't have too many Crohn's issues on Asacol so we stopped the Humira once the fistula's were seen in the MRI results since it wasn't doing me any good.

As a side note, Humira was causing depression for me after being on it a couple of years.

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I've actually had very good luck on Humira, and found it much more effective than Remicade. It's to the point where my fistula is no longer draining, and it never bothers me anymore. It probably varies from person-to-person, though.

I don't know how effective Humira is for actual Crohn's treatment, though. I was already in remission when I had started it. Remicade didn't help me at all for my Crohn's, though. (This is, however, taking into consideration that I was allergic to it.)

Sometimes I feel like it is almost silly to suggest what has worked for us and what hasn't because it really is an individual disease. To the umpteenth power!

Unfortunately! We can just hope for the best. Even within my family the level it varies is incredible. My father also had a fistula, but he was fine just taking Pentasa for years and now he doesn't take anything at all... meanwhile I'm on Humira and my illness is considered very severe.

just to +1 what a lot of people have said. I got my abscess the day after I started Humira and it eventually turned into a fistula. With antibiotics and other treatments I got the outside to close up and even the track to shrink down really small, only to open back up when finishing treatment. It has been going on two years now and I still search for a cure to the fistula/abscess problem without surgery. I have heard many people say that Humira both helped them, but have also heard a lot of people say Humira hurt them in this area so my guess is there are different subsets of Crohn's and it works differently on the subset. Also many people have sworn that Remicade cleared up their fistula problem so I am thinking about giving it a try. Humira was great for my Crohn's for the first year (even though I had the abscess problem it was worth it; trading a greater evil for a lesser) but after the first year it stopped working so I stopped it.

I developed my fistula while on Remicade and then switched to Humira. So, yeah, definitely varies for people.

how did it do on Humira? did it heal by any chance?

Extremely well. It's completely stopped draining on Humira, I have no infection there, and I'm getting out my seton tomorrow. So I'm going to see if it closes after that.

I had fistula before I was diagnosed. I had surgery and antibiotics for some time and it was healed. No other meds at the time. Doctor told me fistulas are supposed to heal from the inside out, so I had to use some sort of dressing inside the fistula to let it heal and to keep it open. It was not seton or anything like they use nowadays. Took some time and care but it healed. I have been washing my butt after every time I go to toilet ever since and it has not recurred.

Awesome. It makes me really happy to hear that people are getting through this well.