Nutrition plays an important role in the treatment of a fistula because good nutrition can help promote healing. Different nutritional treatments are recommended for different types of fistula. However, it is likely that you will be taken off of a regular oral diet and switched to a more aggressive means of nutritional support. Your doctor, nurse and dietitian will monitor your nutritional needs during recovery to ensure proper healing of your fistula and to prevent malnutrition and weight loss.
What is a Fistula?
A fistula is an abnormal connection between two or more tissues in your body; this can occur in many different tissues in the body, and may be a result of disease, infection, surgery or injury. For example, an intestinal fistula can occur between tissues in the intestine and the bladder as a result of intestinal surgery for Crohn's disease. This can be dangerous because it promotes further infection. A fistula will not heal on its own and thus needs to be treated by a medical professional. Treatment will depend on where the fistula is located, but usually involves surgery.
Electrolytes and Fluids
An infected fistula can have a high output of fluid drainage. Because of this, it is important to maintain fluid and electrolyte balance. If you have a fistula, you will likely be admitted to the hospital. Your doctors and nurses will monitor your fluid output and will provide you with intravenous fluids and electrolytes as appropriate. This will not only help keep you hydrated, but will also help to clear the infection and promote recovery.
If the fistula is not in a location that will impair the functioning of the gastrointestinal tract, enteral nutrition -- tube feeding -- may be used to prevent weight loss and low albumin levels. According to "Nutrition and Diagnosis-Related Care" both of these are risk factors for mortality in patients with a fistula. This will help decrease the risk of malnutrition and increase the chances of recovery.
Parenteral nutrition -- or intravenous nutrition -- is most often used to treat fistula patients, especially if the fistula affects the gastrointestinal tract. All of the nutrients your body needs will be included in the intravenous solution, including carbohydrates, protein, fats, water, vitamins and minerals. Parenteral nutrition promotes rest and healing in the body because your body does not have to work as hard to break down and digest food. This gives your body the ability to focus on healing the fistula.
- Medline Plus; Fistula; Linda Vorvick, MD; August 2009
- "Nutrition and Diagnosis-Related Care, 5th edition"; Sylvia Escott-Stump, MA, RD, LDN; 2002