Imagine changing your urostomy bag and spotting what looks like food in there. That’s what happened to Geoff, one of the Urostomy Association’s supporters. He said:
“I just emptied my bag and found it had a bit of grape stuck in it. In the last two months I’ve seen what looks like bits of salad leaf too. But my stoma nurse and doctor say it’s impossible”.
On further investigation at the hospital, Geoff was told that he had a fistula between his small bowel and his urostomy. We spoke to Paul Russell-Roberts, Stoma Nurse Specialist, who shed light on this unusual condition:
What is a fistula?
A fistula is essentially an abnormal passageway between two parts of the body that shouldn’t normally be joined. For example, a connection might occur between someone’s bowel and their urostomy.
Why do fistulas develop?
Fistulas can develop for various reasons. They are often related to underlying inflammation (like Crohn’s disease), previous surgeries, infections, medical conditions such as ulcers, or radiation therapy.
It is not always predictable, and sometimes it’s just down to how someone’s body responds to healing or long-term changes post-surgery.
What are the symptoms?
Symptoms vary depending on the type of fistula. Looking at the example of someone’s small bowel connecting with their urostomy, tiny amounts of bowel content could end up in their bag.
Other symptoms could include pain, fever, poorly-flowing urine, mucus in the urine and sore skin around the stoma. One of the biggest risks is the development of a urinary tract infection (UTI). UTIs can be serious, if you experience any signs of a UTI contact your GP.
What are the treatment options?
Treatment depends on the individual case. Sometimes it can be managed conservatively with monitoring, especially if it’s not causing major symptoms. In other cases, surgery may be needed to correct the connection if it’s persistent or problematic.
Get advice
If you’re concerned that you may have a fistula, then speak to your stoma nurse. You may be referred for a CT scan to explore the matter further.
There are steps you can take to manage symptoms while you wait for further investigation. These include staying hydrated, watching for signs of fever and keeping track of pain, fevers or odd smells. You could also keep notes and take photos of any skin change or odd output.
Please remember
Fistulas among urostomates are unusual, and many can be managed successfully without resorting to surgery.
- Huge thanks to Paul Russell-Roberts, Stoma Care Nurse Specialist, for reviewing this information page
