Hello!
I don't have any suggestions, just commiseration. I had a minor fistula that I lived with for about 10 years (my surgeon did not recommend intervention), until it spontaneously healed (no idea why)...for about 2 years. Unfortunately, when it recurred about 6 months ago, it was much worse and is causing me considerable grief. (Also chronic yeast infections--anyone else dealing with this?) I am also sort of avoiding dealing with this medically as I'm afraid the doctor will finally suggest surgery, and, like you, my pouch is otherwise working fine and I don't want to compromise that. But I don't know how much longer I can put up with this unpleasantness...
Though I can't offer any help, I have to say it was such a relief to discover this forum and find other people who have been going through the same thing! It's not something I tend to bring up in casual conversation with others...
Good luck!