What is Mucous Fistula? Is it something to be afraid of? Let's talk!

You may have seen or heard of people with a small pouch-like structure attached to their abdomen. When you see this, many people wonder, "What is this?" This is usually related to some kind of intestinal surgery. Today we are going to talk about one such surgery. It is a condition called Mucous Fistula. The name may sound a bit complicated, but don't worry. Let's keep it simple and clear.

Simply put, what is Mucous Fistula?

Imagine that a part of our intestine needs to be surgically removed due to illness or temporarily removed from function to give it a rest. Then, the surgeon disconnects that part of the intestine from the connection.

Now think about it this way. Our intestines are not just a tube. They constantly produce secretions from within. We call this mucus . Just like the saliva in our mouths, this mucus-like fluid helps to protect the inner lining of the intestines, prevent them from rubbing against each other, and prevent damage from undigested food particles.

So, when a part of the intestine is severed, that part of the intestine continues to secrete mucus. If these secretions have nowhere to go, they can accumulate inside the severed intestine and cause serious problems like pain and infection.

To prevent that problem, doctors create a mucous fistula .

Simply put, it involves surgically connecting the end of the severed intestine to a small opening (stoma) made in the skin of the abdomen. Then, instead of the mucus produced in the intestine coming out through the anus, the newly created stoma exits the body. This acts like an extra drain.

Why would someone need this kind of surgery?

This surgery is usually done in conjunction with another major surgery. Most of the time, this is necessary for certain intestinal conditions. Let's take a look at what those are.

Do small babies need this too?

Yes, sometimes newborn babies also have to undergo this surgery. This is mainly due to two birth defects.

1. Imperforate anus: Some babies are born without an anus. So, a way to pass stool needs to be created for them. A temporary colostomy and mucous fistula are created for this. Once the baby is a little older and stronger, this is used until the anus is repaired with corrective surgery.

2. Intestinal atresias: Some babies are born with parts of their intestines blocked or disconnected. If this cannot be fixed with a single surgery, a temporary mucous fistula may be needed.

How is this surgery done?

As I mentioned before, a mucous fistula is not created on its own. It is usually done in conjunction with another surgery called a colostomy or an ileostomy . Let's take a look at what those two are.

• End colostomy: In this procedure, the surgeon connects one end of your large intestine (colon) to an opening (stoma) made in the skin of your abdomen. Stool comes out of this stoma.
• End ileostomy: This is where the end of your small intestine (ileum) is connected to an opening made in the skin of your abdomen. Stool comes out of this stoma.

A stoma that allows stool to exit is usually a little larger. A mucous fistula is smaller.

When you look at a stoma, it looks pink and moist, like the inside of our cheek. Since it has no nerves, it doesn't feel painful to the touch.

After surgery, an ostomy pouch is placed on the outside of both stomas. Initially, a mucous fistula may also produce a lot of secretions, so it also requires a small pouch. However, over time, the amount of secretions decreases. At that point, it may be possible to keep the pouch covered with gauze instead of a pouch.

How should I prepare before surgery?

Since this is a major surgery, you need to prepare well in advance. Your doctor will explain this to you in detail. Here are the things you will usually be asked to do:

• Fasting: You will need to completely abstain from food and drink for several hours before the surgery.
• Stopping Medications: Your doctor may advise you to temporarily stop taking certain medications (especially blood thinners) before surgery.
• Quitting smoking: This is very important. If you are a smoker, you should stop smoking at least a few weeks before your surgery. Smoking increases the risk of complications after surgery and delays wound healing.
• Bowel cleansing: The doctor will give you a special liquid (bowel prep) to drink to completely cleanse your intestines before surgery.

Is this permanent? Will it last forever?

This is a question that scares many people when they hear it. But the good news is, most of the time, this is not a permanent thing.

For many people, a mucous fistula and the associated colostomy/ileostomy are created temporarily.The main goal here is to give the inflamed and damaged intestines some rest and time to heal.

This healing process can take weeks, months, or even a year. Once your bowel is completely healed, your surgeon can perform another operation to reconnect the severed parts of your bowel. After that, you will be able to have normal bowel movements again.

What are the risks and complications of this?

As with any surgery, there are risks and complications that can occur, but not everyone will experience these.

What time do you need to call the doctor?

Once you get home after surgery, you should be on the lookout for certain warning signs. If you notice any of these, you should call your doctor without delay .

• If you have a fever or feel chills (these could be signs of an infection).
• If nausea and vomiting persist.
• If there is excessive bleeding from the stoma or with stool.
• If you have difficulty defecating or urinating.
• If the stoma changes color (for example, if it turns dark purple or black).