Does rich fiber diet accelerate the healing process of low-output colorectal fistulas?

The occurrence of an anastomotic leakage is a major therapeutic concern in colorectal surgery. Considering the outflow level of the fistula, a defunctioning stoma may be necessary to obtain closure. When the outflow is low and the intestinal transit is not interrupted, a colostomy is not mandatory but the healing process can be long. Here the author presents three consecutive cases of low output fistula treated by feeding with an enriched fiber diet. Closure of the fistulae occurred in a few days. The rationale of this alternative treatment is discussed.