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Managing Symptoms at Home

It can take time for the medicines and/or surgical procedures to heal and close the Crohn’s perianal fistula. During this time, your doctor and other members of your healthcare team may suggest things that you can do at home to make you feel more comfortable. Scroll down for some general tips, but make sure to talk to your medical team to learn how to take care of the skin around the fistula and how to manage swelling and pain. 

Taking Care of the Skin Around the Fistula  

Below are some tips on how to take care of the skin around the perianal fistula: 

Hand Hygiene

Gentle Cleaning

Use warm water and a soft cloth to clean the area around your fistula. Bidets or sitz baths can also help keep the area clean. Don't rub too hard but pat the area dry or use a hair dryer on a cool setting to dry it.

Image by Chandler Cruttenden

Regular Bathing

Take showers or baths like you normally would. If you take a bath, do not add soap, salt, or perfumed products to the water. Afterwards, pat dry the area near your fistula with a towel.  

Soap Bar

Sensitive Skin Products

Use a gentle soap made for sensitive skin when cleaning the skin around the fistula. Don’t use strongly perfumed products or talc as that may irritate the area. 

Image by Towfiqu barbhuiya

Post-Bowel Movement Care

After having a bowel movement, gently clean the area near the fistula with baby wipes or consider using a Bidet on a gentle setting. 

Image by Nataliya Melnychuk

Barrier Creams 

Your doctor may recommend a barrier cream for the skin around the fistula. Do not use any other creams or lotions unless your medical team says it’s okay. 

Diet, exercising, and being consistent help you feel in control of your own health.

Managing Swelling and Pain

Below are some tips on how to manage swelling and pain related to the perianal fistula:  

Image by Agata Create
Clothing Rack
Image by mk. s

Comfortable Seating

Loose Clothing

Warm Sitz Baths

Using cushions or pillows can make sitting feel better. There are special cushions, such as ring cushions and those made from Tempur-Pedic®, that can help with the pain. If sitting is too uncomfortable, you can lay on your side on a bed or couch. 

Wearing loose-fitting clothes and cotton underwear may help with the pain. 

Sorting Medicine

Doing warm sitz baths a few times a day may help. This involves sitting in a tub of warm water that covers the skin around your anus. It can help reduce pain and swelling. 

Stomach Ache

Pain Management

You can take over-the-counter medicines, like acetaminophen (Tylenol®), to help with pain. Do not take NSAIDs like ibuprofen (Motrin®) or naproxen (Aleve®) as they could cause your Crohn’s disease to flare. 

Prevent Constipation

Avoid getting constipated as that could worsen pain. Eating a high-fiber diet with lots of vegetables and fruits can help prevent constipation. If needed, you can also ask your doctor about using a gentle laxative like polyethylene glycol 3350 (Miralax®).  

When to Call Your Doctor

Male doctor giving advise

You should call your medical team whenever you have any questions about your Crohn’s perianal fistula. Definitely call your doctor or go to the hospital if you have any of the following symptoms:

  • Severe pain, swelling, warmth, or redness near your fistula—this could be a sign of an abscess (i.e., pocket of infection) 

  • Fever greater than 100.4F 

  • Lightheadedness, dizziness, or passing out 

  • Bleeding from your rectum or fistula 

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