Side Effect: Fistula (abnormal connection between tissues)

An abnormal connection or passageway between two tissues or structures in the body is called a fistula. Fistulas can develop within and between various parts of the body, including the digestive system, urinary tract, and reproductive system.

The appearance and symptoms of a fistula depend upon its location in the body. A fistula may look like a small hole or opening on the skin, or it may be hidden inside the body. Some patients may experience symptoms due to the fistula, while others may not experience any symptoms at all.

Common symptoms of a fistula include:

• pain
• swelling
• redness
• drainage of fluid or pus
• foul-smelling discharge

• Fistulas are most commonly caused by trauma, infection, inflammation, or surgery.
• Some medical conditions, such as Crohn's disease or ulcerative colitis, may increase the risk of developing a fistula in the digestive tract due to the destructive nature of these diseases.
• Patients with cancer may be at increased risk of developing a fistula, particularly if they have undergone radiation therapy or surgery in the affected area.
• The use of bevacizumab (Avastin®, Mvasi®, Zirabev®) after radiation or surgery may also increase the risk of fistula formation, although the risk may vary from person to person.

Preventing fistulas depends upon the underlying cause. Managing chronic conditions like Crohn's disease or ulcerative colitis can reduce the risk of fistulas in the digestive tract. Preventing infection and taking proper care of wounds after surgery can also help prevent fistulas from developing.

• Treatment of fistulas may depend on the location and severity of the fistula, as well as the patient's overall health and treatment goals.
• Antibiotics to help prevent or treat infection as well as nutritional support as key aspects of fistula management.
• Certain medications can be utilized to slow drainage or output or manage other symptoms related to the fistula.
• Some fistulas may spontaneously close over time, while others might require surgical intervention to be closed.