Anal Fistula

Anal fistula is a type of anal disease . After the food is digested in the stomach, the remaining part starts accumulating in our rectum as a stool. When the rectum is full, the pressure of the stool is created and during defecation, the stool comes out of the body through the anus through the anus.

Infections or boils can sometimes be caused by bacterial infections of the skin around the anus. Many times these boils cause pus to come out and cause deep wounds, which form a kind of road with the anus. This type of abnormal passage with an anus other than the anus due to an abscess or any other cause is called anal fistula or anal fistula. To many it is also known as fistula.

This type of fistula or fistula can cause various symptoms including itching and burning around the anus. These fistulas usually do not get better on their own without treatment. In most cases surgery is needed to cure the fistula.

Symptoms of anal fistula

Fistula or fistula of the anus can cause a number of symptoms. E.g.

• Burning or itching of the skin around the anus
• Pain around the anus. There is usually a constant tingling pain which is aggravated by sitting, walking, coughing or defecating.
• Stinky pus coming out of the area around the anus
• The area around the anus becomes swollen and red. If there is boil with it, fever can also come
• Blood and pus coming out of the stool
• In some cases the control over the toilet may go away. That is, the patient may no longer be able to hold on to the pressure of the bowel movement, or the bowel movement may occur before he realizes that the bowel pressure has come.

In many cases the fistula passage can be seen from the outside like a hole in the skin around the anus. However, it is usually difficult for the patient to see for himself.

Causes of anal fistula

In most cases, fistulas are formed from abscesses around the anus. This usually happens when the boil does not dry properly after the pus has come out.

There are other possible causes of anal fistula. E.g.

1. TB (TB) / HIV (AIDS): Anal fistula can occur in patients with these diseases.

2. Anal operation: If there is an operation around the perforation of the anus, then a new passage may be formed from there and anal fistula may appear.

3. Crohn’s disease: It is a disease in which there is inflammation in the digestive tract. Symptoms include diarrhea, abdominal pain, or blood in the stool.

4. Diverticulitis: In this disease, the last part of the digestive tract (colon) becomes swollen like a sac and there is an infection.

5. Hydradenitis sapurativa: It is a disease in which the skin is boiled and the skin becomes thick and scarred in the parts of the body where sweat is more.

What to do in case of anal fistula

If the symptoms of anal fistula persist for a long time, you should see a doctor without delay. The doctor will want to know the details about the symptoms. You will also want to know if there are any other problems in the intestines or stomach.

At this time the doctor will examine the area around the anus if necessary. You can also examine the fistula by inserting a finger gently through the anus to understand the condition of the fistula. This procedure is called DRE (Digital Rectal Examination).

If the examination shows that there is an anal fistula, the doctor will advise the patient to go to the specialist doctor (colorectal surgeon) if necessary. The specialist doctor will do some more tests to confirm the fistula and decide on the appropriate treatment or operation.

The tests that can be done in this case are:

• Re-examination may be performed by inserting a finger into the DRE or anus
• Proctoscopy may be performed where a special tube-like device is inserted through the anus. It helps to see if there is a fistula
• Ultrasound scans, MRI or CT scans may also be performed

Anal fistula treatment

In most cases surgery is performed as an anal fistula. Because it usually does not get better without surgery. The operations that may be performed in this case are:

1. Fistulatomy: This procedure involves cutting the entire fistula duct or duct and removing the remaining pus. It is then sewn as required or allowed to dry without sewing. After drying, the place becomes healthy as before

2. Seton method: In this method, a special type of yarn called Seton is inserted inside the fistula for a few weeks. This yarn absorbs the pus and helps to dry out the fistula. The fistula is then completely healed in a few more steps

3. Advance Anal Flap : This procedure involves bringing a piece of tissue or flesh from another part of the body (usually from the end of the anus) to the fistula passage. Adding new parts in this way increases blood flow to the fistula. As a result, it heals faster and the fistula no longer needs to be cut off the entire way.

4. ‘Lift’ method: This method is followed if there is a fistula inside the muscle that controls the movement of the stool in the toilet. In this method, only the fistula is removed without cutting the muscles.

In addition to these methods, nowadays laser and fibrin glue are used to treat anal fistulas in addition to direct surgery. Fistula treatment usually does not require hospital stay all day. However, in some cases it may be necessary to stay in the hospital for a few days after the operation.

All methods of treating fistula have some advantages and some disadvantages. Considering the overall situation, the doctor will choose the method that will be best for the patient.

Problems that usually occur after surgery

The most common complications after anal fistula surgery are:

• Infection : It usually gets better with antibiotics. However, if there are many more infections, it may be necessary to seek treatment from the hospital.
• Recurrence of fistula: Fistula may recur in the same place many times after surgical removal.
• Unable to control bowel pressure: This condition can be treated with any type of fistula. But usually it doesn’t cause much problem and it gets better by itself.

The severity of these problems usually depends on where the fistula has occurred and the method by which it is being treated.