Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency help for signs of severe infection, bleeding, or dehydration, including:
Confusion, fainting, extreme drowsiness, or difficulty staying awake
Trouble breathing, cold or blotchy skin, or rapidly worsening weakness
Heavy bleeding from the fistula, rectum, vomit, urine, or vagina
Severe or rapidly worsening abdominal pain
Very little urine, especially with dizziness or inability to drink
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Contact your healthcare team promptly if you develop a fever, increasing pain, new swelling, pus, a strong change in drainage, repeated vomiting, or worsening redness around the opening.
A sudden increase or decrease in fistula output also needs assessment because it may reflect a change in the tract or a blockage.
3
Does any of this apply?
Book an appointment
Routine follow-up is important even when you feel stable.
It is used to monitor nutrition, fluid balance, skin health, the underlying condition, and whether the fistula is closing.
Every sign above is quoted from the sofidex article on Gastrointestinal fistula. If you are not sure, err upward — it is always reasonable to be checked.