I have a drain in an abscess cavity with a connecting fistula between the cavity and my anal canal. How likely would it be for a fistula to form from the anal canal to the vagina, and what would the symptoms be? Nothing has worked to close the perianal fistula — I've tried Remicade, 6-MP, an advancement flap, and plugs.

Fistulas are abnormal communications or passages from the gastrointestinal tract to the skin or other organs, such as the vagina, and they are characteristic of Crohn’s disease. Passage of stool and gas through the vagina or urethra are symptoms you would expect if there were a fistula to the vagina or the bladder from the anal canal.

Surgical drainage of any abscess is an important first step in the management of fistulas, but a combination of medical and surgical therapy usually works best. It seems as though you could benefit from another opinion from experienced physicians, preferably at a major medical center where there are experts in gastrointestinal conditions like Crohn's and colitis.

Learn more in the Everyday Health Ulcerative Colitis Center.