Gastrointestinal fistula

Most gastrointestinal fistulas occur after surgery. Other causes include:

• Blockage in the intestine
• Infection (such as diverticulitis)
• Crohn disease
• Radiation to the abdomen (most often given as part of cancer treatment)
• Injury, such as deep wounds from stabbing or gunshot
• Swallowing caustic substances (such as lye)

Depending on where the leak is, these fistulas may cause diarrhea, and poor absorption of nutrients. Your body may not have as much water and fluids as it needs.

• Some fistulas may not cause symptoms.
• Other fistulas cause intestinal contents to leak through an opening in the skin.

Tests may include:

• Barium swallow to examine the stomach or small bowel
• Barium enema to examine the colon
• CT scan or MRI of the abdomen to look for fistulas between loops of the intestines or areas of infection
• Fistulogram, in which contrast dye is injected into the opening of the skin of a fistula and x-rays are taken

Fistula treatment focuses on treating the underlying cause of the fistula and any associated infection.

Treatments may include:

• Antibiotics
• Immune suppressing medicines if the fistula is a result of Crohn disease
• Nutrition through a vein while the fistula heals (in some cases)
• Surgery to remove the fistula and part of the intestines, if the fistula is not healing

Some fistulas close on their own after a few weeks to months.

The outlook depends on the cause of the fistula, the person's overall health, and how bad the fistula is. People who are otherwise healthy have a very good chance of recovery.

Fistulas may result in malnutrition and dehydration, depending on their location in the intestine. They may also cause skin problems and infection.

Contact your health care provider if you have:

• Very bad diarrhea or other major change in bowel habits
• Leakage of fluid from an opening on the abdomen or near the anus, particularly if you have recently had abdominal surgery

Entero-enteral fistula; Enterocutaneous fistula; Fistula - gastrointestinal; Crohn disease - fistula

Nassar AK, Barera D, Perrone K, Pugh C. Gastric, duodenal, and small intestinal fistulas. In: Ahmad SA, Pryor AD, eds. Shackelford's Surgery of the Alimentary Tract. 9th ed. Philadelphia, PA: Elsevier; 2026:chap 77.

Wadhwani N, Gunnells D. Abdominal abscesses and gastrointestinal fistulas. In: Chung RT, Rubin DT, Wilcox CM, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 12th ed. Philadelphia, PA: Elsevier; 2026:chap 29.

Updated by: Todd Eisner, MD, Private practice specializing in Gastroenterology in Boca Raton and Delray Beach, Florida at Gastroenterology Consultants of Boca Raton. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.