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Inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis, can increase your risk of developing some types of fistulas. If you have symptoms of a fistula and you also know or suspect that you have an inflammatory bowel condition, let your doctor know.  You may have IBD if you experience persistent diarrhea, abdominal cramps, bloating, bloody stools, fever, nausea, and unexplained weight loss.  Diverticulitis, a condition in which small pockets form in the colon and become inflamed or infected, can also lead to fistulas. Fistulas can occur during a difficult or complicated childbirth. Fistulas between the rectum and vagina are particularly common, but you might also develop fistulas around the outside of the anus. After childbirth, follow up regularly with your OB-GYN to make sure any injuries associated with the delivery process are healing up properly. Call your OB-GYN right away if you have recently given birth and are experiencing any symptoms of an infection or fistula, such as fever, pain, or bad-smelling discharge. Any kind of injury to your bowels or pelvic region can put you at risk of developing a fistula. This type of injury may result from trauma (for example, an injury caused by a car accident) or from a complicated pelvic surgery (such as a hysterectomy). You can also develop fistulas as a result of infection, cancer, or radiation therapy that affects your pelvis.  Injuries due to radiation therapy may take a long time to develop. If you've had pelvic radiation treatment, you may develop a fistula 6 months to 2 years later. Some types of sexually transmitted infections, such as chlamydia and HIV, may put you at greater risk of developing a fistula.
Determine if you have an inflammatory bowel condition. Look at your childbirth history, if applicable. Examine any history of pelvic injury or infection.