I have perianal Crohn's disease. My problem is that I have a fistula that drains and has an odor. How can I get rid of the odor?

Jason

Crohn's is a chronic inflammatory disorder of the small and/or large intestine that leads to diarrhea, blood in the stool, abdominal pain and fever. Crohn's can lead to obstruction of the intestine because of swelling or scarring. Another common complication of Crohn's is the formation of fistulas and abscesses. Fistulas are abnormal connections between two organs. In patients with Crohn's, they may form between the bowel and the bladder, the bowel and the vagina or the bowel and the skin near the anus (perianal fistulas).

As you have experienced, perianal fistulas can be very bothersome. Medications are sometimes given to promote the healing of the fistula. Such medications include antibiotics (ciprofloxacin, metronidazole) and anti-inflammatory drugs (6-mercaptopurine, azathioprine). Even with these medications, fistulas may take weeks or even months to heal. Non-healing fistulas are sometimes surgically removed once active infection around the fistula has resolved. Recently a new medication has become available that appears especially useful in Crohn's patients with fistulas. Studies have shown that this anti-inflammatory medication, infliximab (Remicade), is very effective in closing fistulas, and often works very quickly (two to three weeks).

In your case, the presence of a strong odor makes it very important to rule out that your fistula is not accompanied by a secondary infection or abscess. You should find a gastroenterologist who takes your concerns seriously and is willing to take the time to discuss all the possible medical and surgical therapies for perianal fistulas.