Anal Fistula – Holding On … Is it Worth it?

By Anonymous, UK

In January 2018 I was diagnosed with an anal fistula. A fistula is a tunnel that has formed with an opening at either end, one outside the anal entrance and one – or more, as in my experience I had two – inside. It becomes increasingly painful to sit, poo and move around and then very painful 24/7. It can be caused by Crohn’s disease, diverticulitis or certain other bowel conditions. It can develop as a consequence of an abscess forming and then bursting, and often is accompanied by constipation initially. It is notable for the pain experienced.

The main form of treatment is surgery. The fistula or the tunnel can be opened up from one end to the other all in one go or in stages. There is a risk of incontinence in some types of fistula that involve the anal sphincters if they are opened all at once. An alternative approach is to insert a Seton suture – which is usually a length of plastic which is put through the tunnel and tied in a loop and this helps to drain the fistula and it can then be opened up gradually over a number of weeks rather than all at once.

My symptoms had started with what seemed like faecal incontinence which only happened after I had passed stool. I left this alone for a while to see if it would stop on its own, like many of us do. It didn’t, I was leaking poo through the fistula, leaving me sore, uncomfortable, inflamed and concerned. I had bleeding from my anus and a lot of pain. As time went on my anus became swollen and bright red most of the time, looking and feeling a lot like bad sunburn. I didn’t however have an abscess or any other bowel condition, though I regularly had constipation. Continue reading “Anal Fistula – Holding On … Is it Worth it?”

A 15 year ‘longitudinal’ study on health and wellbeing (aka – my body knows best).

By Manager in Healthcare, UK 

Over many years, I have collected thousands of articles about lifestyle and the impact on our health, as well as articles about health, well-being, workplace health, non-communicable diseases, women’s health, including a range of studies that have been published from medical and other journals, undertaken by a range of researchers. These include randomised controlled trials, longitudinal studies, quantitative and qualitative studies, epidemiological studies, and surveys of all sizes, though often quite small cohorts. Along with this research, I have undertaken my own longitudinal study.

There are a few things that strike me in having read these published studies:

Very often the messages are contradictory – e.g. some say coffee is bad for you, and others say coffee is good for you, or red wine is good for you, or red wine is bad for you – raising a number of questions e.g. how do we know something is ‘good’ for us? On what basis? How come there are contradictory messages – given that some of these articles are based on ‘research’ studies? How could two similarly undertaken research studies about the same topic, e.g. coffee or red wine, come up with very different results, when the outcome could be potentially catastrophic for the recipient (e.g. the person drinking the wine or coffee because they now think it is ‘good’ for them)?

A number of the articles are ‘evidence-based’ – which suggests that the outcome of the study has been based on best available ‘evidence’ e.g. based on sound research and not based on opinion. And whilst there is much written about evidence-based practice, evidence-based medicine, evidence-based research, this opens up the question of what is ‘evidence’ in any given circumstance? The current definition of evidence-based practice is “the integration of critically appraised research, with clinical expertise, and the client’s preferences, beliefs and values” (1).

Continue reading “A 15 year ‘longitudinal’ study on health and wellbeing (aka – my body knows best).”