Rectovaginal Fistula Causes

What causes or contributes to a rectovaginal fistula? Are there dietary considerations, and how is the microbial environment involved? Lastly, what can be done to treat this rare but distressing condition?

I received a question via email from a woman who found me through my popular post on natural healing for fistulas (274,800 views and 471 comments!):

I’m 70 years old and I’m leaking something strange from the vagina. Doctors suspect there is a tiny fistula connecting the colon to the upper left anterior of my vaginal wall.

This woman was really mystified as to what caused the recto-vaginal fistula and what she could do to heal it. When I asked for more details, here is the sequence of events that preceded the fistula:

  • Water fast (with electrolytes) for a month, followed by a 2 week fast of clear natural pressed juice with small, occasional amounts of a psyllium product called Intestinal Clenz so that she didn’t keep having ‘accidents’ from the detox flush (diarrhea). Also supplementing with magnesium.
  • Discharge from vagina begins, she suspects a yeast infection. Begins eating her regular diet, goes on a trip to visit Grandkids. But has to return home due to the pain. Doctor immediately puts her on 2-week course of Zosyn antibiotic – go ahead and click that link to see a full list of the ‘side effects’.
  • After 2 weeks on Zosyn, doc calls with results of the PAP test (vaginal swab) and tells her to get to hospital immediately as she has an E.coli infection. She is put on 5 days of intravenous Zosyn and then sent home with 8 more weeks of IV antibiotics at home.
  • Doctors do 2 CT scans in hospital and diagnose her with diverticulitis, but can’t be sure as bilateral hip implants make it difficult to see. She is now scheduled for a colonoscopy she doesn’t want.

My thoughts on what caused the rectovaginal fistula

I apologize in advance if anything I’m about to say sounds judgmental or critical. I really am not judging anyone here. Just giving my perspective and personal opinion, based on my own knowledge and experience. Keep what’s useful/helpful, throw the rest out.

What I’m not sure of here, is why she went on such an extreme and prolonged fast in the first place? She wrote that she underwent the fast to end a 40-year dependence on pain medication for migraines. I have to imagine that she had a doctor guiding her with a history of success with this protocol…

But from a gut perspective, I can think of very few reasons why 4 weeks of nothing but water and electrolytes could be helpful. We have to think of our bodies from an evolutionary and psychological viewpoint. In the thousands of years of our existence, what does 4 weeks of no food signify to the human? This is extremely stressful biologically.

Bacterial Vaginosis, Yeast Infections concept with woman having a problem with Vaginal Odor

In discussing his book, When The Body Says No, Dr. Gabor Maté talked about a study where subjects claimed to feel no stress. But their bodies were registering clear and significant stress markers/signs. They had no conscious awareness of the stress their bodies were feeling.

From a gastrointestinal perspective, spending 4 weeks emptying the gut of everything, without simultaneous probiotic supplementation, is opening the door to opportunistic infection. It’s the same reason we should never take antibiotics without therapeutic-grade probiotics.

Then, after 4 weeks of clearing the gastrointestinal tract of its microbiome, having her consume nothing but pressed juice for 2 weeks, then flooded the GI tract with… sugar! What is the preferred food of yeast/fungus and bad bacteria? Sugar.

All about the Intestinal Clenz

She mentions that she’s also taking magnesium (which stimulates bowel movements) but when the diarrhea gets too intense, she would take psyllium. I looked up the ingredient list of the psyllium product she used, called Intestinal Clenz:


  • Psyllium (seed and husk)
  • Alfalfa (leaves)
  • Rosehips (Rosa canina) (fruit)
  • Buckthorn (Rhamnus frangula) (bark)
  • Cascara Sagrada (bark)
  • Lactobacillus Acidophilus
  • Montmorillonite Clay
  • Cayenne Pepper (fruit)
  • Garlic (bulb).

It contains a potent laxative (Cascara Sagrada), along with Montmorillonite clay (commonly called bentonite clay) which will remove all bacteria it can adsorb. I would think cayenne pepper would also be pretty harsh on a stripped gut.

What Role does Diet Play?

But let’s also take a look at her normal diet, before she began this fast/cleanse:

Homecooked organic food – LOTS of raw veg and fruit, fiber-rich grains, low sugar, low salt, very little meat, fresh-pressed juice.

From many perspectives, this may look like a healthy diet. From my perspective, it is not a good diet for digestive health.

To heal a digestive disease, we avoid grains entirely, eat cooked vegetables, fruit only in isolation, but not much due to the sugar. Same thing for fresh-pressed juice – too high in sugar (unless you’re only pressing veggies like celery and cucumber). Eggs, wild fish and chicken are the most easily tolerated protein sources to begin with. Then you work your way up to lamb, venison, beef.

You eat as much good fat (organic, pasture-raised) as you can tolerate – and as you heal, you can tolerate more: butter, ghee, extra-virgin olive oil, coconut oil, duck fat, beef tallow and cold-pressed flax oil. Bone broths, with natural gelatin are very healing for the gut. You avoid phytates (unsoaked, unfermented grains) and oxalates (raw spinach, kale, etc). Sea salt is encouraged.

So in my experience, her raw, high grain/carb diet actually set her up for gastrointestinal problems. Pain meds can also predispose you to gut issues. Drugs like aspirin cause direct bleeding in the GI tract, while others create an alkaline pH – which encourages the growth of bad bacteria and inhibits the good bacteria.

How does the Bacteria Transfer from the GI Tract to the Vagina?

In my recent livestream with the founder of Natren probiotics, we discussed the frequent transference of bacteria from the GI tract to the vagina. They are right next to each other. It’s pretty hard to have one healthy and the other not. Issues like improper wiping, diarrhea, and sex increase transference.

It’s hard to know what the initial vaginal discharge signified. But the initial 2 weeks of antibiotics into a GI tract that had already been wiped clean of beneficial, protective bacteria, was a recipe for disaster. How much did the antibiotics contribute to her present condition? This is only one of the warnings from the drug info on Zosyn (emphasis mine):

Tell your doctor if you have serious side effects of Zosyn including muscle cramps or spasms, swelling of the arms/legs/hands/feet, easy bruising or bleeding, chest pain, confusion, new signs of infection (such as fever, persistent sore throat), severe abdominal or stomach pain, slow/fast/irregular heartbeat, persistent nausea or vomiting, seizures, extreme tiredness, dark or cloudy urine, change in the amount of urine, yellowing eyes or skin, or serious skin reactions (rash, peeling, sores, or blisters).

So now we have a bit of a roadmap as to how and why the rectovaginal fistula and intestinal infection developed. Remember that a fistula is simply a drainage hole for infection. Infection (overgrowth of pathogens) cannot remain in the body, or it can kill you. In men, the body creates a fistula/drainage hole in the perianal area or even through the tailbone.

Natural Remedies for Rectovaginal Fistula

I have detailed instructions on all of the protocols and treatments for rectovaginal fistula that I know of. Including diet, emotional healing, syringing protocols, infrared laser, vaginal probiotic paste, and more. Go ahead and click that link.

In this woman’s case, she has a bigger issue than just the fistula that she asked for help with. And having a colonoscopy is going to scrub her colon clean of it’s bacterial flora again, and expose her to infection from the scope itself. Definitely download my ebook on What You Need To Know About Colonoscopy for pre- and post-colonoscopy treatment to minimize risks, and also check out this patient’s story.

Her story not only reveals how colonoscopies can be damaging, but also how illnesses can snowball as the drugs create new and multiple issues.

Due to the state of her gut microbiome, this woman now needs to heal her entire gastrointestinal tract. She now needs my book, Listen To Your Gut. Or at  the very least, Jini’s Natural Healing Guide: Gut Infection. It’s going to take a good 6 months to replace her gut microbiota with beneficial flora, heal the mucosal lining and strengthen the intestinal wall.

And then there’s the deeper levels of healing…

The Body Signposts the Way

For this woman, and all you reading this, I encourage you once again to delve into the spiritual/emotional messages of your illnesses. The body is the messenger for the subconscious. Symptoms are always messages. In rare cases, the message is simply to change something in the physical realm.

But for anything serious, or chronic, the messages will involve spiritual and emotional health as well. In this woman’s case, her body was already messaging her (quite strongly and insistently) with the migraines.

My body is speaking… what is it saying?

Whether she explored soul-level healing or not, she didn’t get to the root(s), she didn’t receive all the messages. So now there are more messages – or they have gotten louder and bigger.

There are no shortcuts on this healing journey called Life. The sooner we lean in, the sooner we can embody our authentic self.

p.s. And remember, for anything that ails you, head over to my Home Remedies section to see if I have a tried-and-tested natural treatment for you. I have over 350 pages of natural remedies, all free! So either check there, or use the keyword search box on my blog here.