A mucous fistula is a surgically created opening that allows the body to drain mucus from a disconnected segment of the bowel. This intervention is a planned part of certain procedures, designed to manage secretions and prevent complications from mucus accumulation.
Understanding a Mucous Fistula
A mucous fistula involves bringing a segment of the intestine to the surface of the skin, forming an opening through which mucus can drain. This opening appears as a small, pink, and moist area, similar to the inside lining of the mouth, often located on the abdomen. Unlike a colostomy or ileostomy, which are created to drain stool, a mucous fistula specifically manages mucus produced by the portion of the bowel that has been bypassed or disconnected from the digestive stream.
The intestines naturally produce mucus to lubricate and protect their inner lining. When a bowel section is disconnected from the digestive path, it continues to produce these secretions. The mucous fistula ensures this mucus exits the body, preventing buildup and pressure.
Reasons for Formation
Mucous fistulas are most commonly created during specific bowel surgeries, particularly when a part of the intestine is disconnected but not entirely removed. One common scenario is during a Hartmann’s procedure, where the lower part of the colon is removed or bypassed, and the remaining rectal stump is closed off. In such cases, the mucous fistula allows the isolated distal segment to drain its natural mucus production, preventing issues like pressure buildup or a “blind loop syndrome.”
This surgical creation is also frequent when an end colostomy or ileostomy is formed, leading to two separate openings on the abdomen: one for stool and a smaller one for mucus. Conditions like inflammatory bowel diseases (Crohn’s disease, ulcerative colitis), colorectal cancer, diverticulitis, or intestinal trauma can necessitate these procedures. In infants, mucous fistulas may be formed to address birth defects such as imperforate anus or intestinal atresias, providing a temporary drainage solution.
Care and Management
Caring for a mucous fistula involves simpler routines compared to managing a stoma that drains stool. The primary focus is on keeping the area clean and dry to prevent skin irritation. Daily cleansing with warm water and mild soap, followed by gentle drying, helps maintain hygiene. Regular changes of dressings or absorbent pads are sufficient for minimal mucus drainage.
Specialized collection pouches, often used for stool-draining stomas, are usually not required for a mucous fistula, though a smaller pouch may be used initially for substantial drainage. As drainage decreases, a simple gauze pad, bandage, or stoma cap can cover the opening.
Potential Concerns and When to Seek Medical Attention
While a mucous fistula is well-tolerated, it is important to monitor the site for any changes indicating a problem. Signs warranting medical attention include significant swelling, increased redness, or unusual color changes. Any increase in drainage or changes in its appearance, such as pus or blood, should also be reported to a healthcare provider.
Pain around the fistula site, fever, or other signs of infection also indicate a need for prompt medical evaluation. Complications like skin irritation, separation of the stoma from the skin, or narrowing of the opening can occur. Consulting a healthcare professional ensures timely intervention and management of any emerging concerns.