Anal fistula

[Bherman8]

I was diagnosed with microscopic colitis 10 years ago based on a colonoscopy I received while dealing with H Pylori. I was told everything looked normal during the colonoscopy but inflammation was noticed while examining my biopsies. My symptoms have been very mild over the last 10 years, no quality of life changes, just more frequent bowel movements and loose stools sometimes, but I have recently developed an anal fistula. Does anyone know if fistulas are related to microscopic colitis or more likely to develop in mc sufferers then the general public, I can only find a link between them and crohns? Can microscopic colitis and Crohns be easily mistaken for each other even by colonoscopy? I haven't had to do anything to manage my mc over the last 10 years, no drugs, diet changes or anything. I know I have read fistulas are a hallmark for Crohns disease so now I am concerned that I was either misdiagnosed 10 years ago and actually have Crohns or am developing it now.

[Gabes-Apg]

welcome to our group

my thoughts on your questions:

- anyone can get anal fistulas - having something like Crohns may increase the occurrence.
- the gastro specialist would have to be quite bad/incompetant if he was to confuse Crohns and MC. Crohns has strongly visable indicators during the colonscopy. MC is only confirmed when biopsies are taken during the scope, and reviewed by pathologist.
- it is possible to have both Crohns and MC (we have a few members of this group that have both conditions)

whether you have just MC, MC and Crohns, or other IBD, the root cause of issues and symptoms is the same - inflammation
reduce exposure to the triggers causing inflammation and the symptoms will reduce.
ensure that you have good levels of things like Vit D3, and magnesium and the body can heal from inflammation

hope this helps.

[tex]

Hi B,

Welcome to our Internet family. MC and Crohn's disease have certain characteristics in common. For one thing, both can affect any part of the GI tract. That's not true of the other IBDs. And like Crohn's, MC is associated with an increased risk of anal fistulas. While it's not a common problem with MC, it's also not particularly rare, either, and over the years we've had a small but significant number of members who have developed anal fistulas.

As Gabes mentioned, it would be extremely unlikely that Crohn's disease would be misdiagnosed as MC. Having MC does not increase the risk of developing Crohn's disease, but it probably does not decrease the risk, either. IOW, we have basically the same risk of developing Crohn's as anyone in the general population.

If you actually had Crohn's disease, your symptoms would almost surely be much more severe. There are a couple of non-invasive stool tests available that are reasonably reliable for distinguishing between MC and Crohn's or UC. One, is known as a calprotectin test. Crohn's patients typically show a significantly elevated test result on a calprotectin test, whereas it is unusual for an MC patient to show a test result over about 50 mg/kg (of stool). Rarely, test results for a highly-inflamed MC patient will approach 100 mg/kg, but they will virtually never exceed that level. Crohn's patients, by contrast, will typically show results above 100 mg/kg, often significantly above that level. This test has to be ordered by your doctor.

EnteroLab offers a fecal lactoferrin test that measures the lactoferrin produced by neutrophils. Neutrophil levels are rarely elevated by any significant amount with MC, but both Crohn's and UC are strongly associated with a significantly increased neutrophil level. That makes this test an easy way to screen for Crohn's disease. You can order a test kit directly from EnteroLab, if you want to rule out Crohn's disease without even having to deal with a doctor. Here's a link if you are interested.

https://www.enterolab.com/StaticPages/T ... actoferrin

I hope that some of this is helpful.

Again, welcome aboard, and please feel free to ask anything.

Tex

[Bherman8]

Thank you for your replies. From what I understand, having Crohns stops people from being able to have fistulas surgically corrected. Do you know if having mc is the same, or is surgery used to correct them in mc patients as well?

[Gabes-Apg]

my thoughts (and I am NOT a medical professional) is that there is no black and white answer for this nor is there an one size fits all solution

The surgery would have different considerations for anyone with IBD ie if there is weakness/inflammation in the gut tissue then re-sectioning /flapping type procedures would be reconsidered. If the patient has reasonably healthy gut tissues (ie good healing from right diet and right supplements like Vit D3 magnesium etc) then that type of surgery would be ok if the patient is not having Diarrhea or Constipation issues

I have had anal fissures and heamorroids (some surgical treated) and have recovered from both.

[Marcia K]

Hello. My brother had surgery for an anal fistula. He has not had an official diagnosis, but after several years of diarrhea his wife put it together that gluten was causing his issues. He eliminated gluten from his diet and the diarrhea stopped. (That was prior to my LC diagnosis or I could have helped him.)

[Bherman8]

I do have some questions that I have to bring up to my doctor after re-reading through my MRI results. It says I have an inflamed collection in my perineum with no signs of abscess with a small fistula extending from that toward the perianal region. That doesn't match what I read about anal fistulas that go from glands inside the anal canal to outside on the skin. It says it starts in a "collection" in my perineum, which I can feel which is why I initially went in in the first place. The swelling isn't right near the anus. I've had a cyst before in my chest and that is what I thought it felt like. There is no mention of anal canal involvement, just the fistula extending toward the perianal region. Anybody have any idea what that means?

[tex]

That description sounds atypical.

Tex