SURGERY BECAUSE OF A FISTULA IN CROHN'S DISEASE

Sometimes medical treatment with antibiotics and biologics can clear an internal fistula. That's when the intestine connects to another loop of intestine or to the bladder or the female organs. An abscess, a pocket of infection, may develop. When the medicines don't work to close the fistula, surgery is usually required. 

An external fistula, where the bowel connects to the skin, requires a different type of surgery. A thread or flexible wire (a seton is placed through the track that tunnels from the bowel to the skin to make sure the track can drain, while the antibiotics and biologics do their job. It is often a long, slow process to get the area to heal. 

If the external fistula does not drain out to the skin, an infected area called an abscess can form. This may need to be drained, so that it doesn't cause problems with bowel elimination or other complications.