Anal Fistula is formed especially to the person who has anal abscess earlier; it is a type of opening in the anal area filled with the pus. The small gland in the anus gets infected and causes an abscess. The symptoms include swelling, pain, redness and irritation around the skin of the anal canal, with the discharge of the pus through the fistula. Diagnosis and treatments are available of this, although antibiotics are also considered as one of the best ways to care fistula.
Causes of Piles:
1. Blind Fistula, which is open on one end only but connects two structures.
2. Complete Fistula which has both, an external and internal opening.
3. Horseshoe Fistula that connects the anus to the surface of the skin near the anus after going around the rectum.
4. Incomplete Fistula which has a tube that starts from the skin that is closed on the inside and does not connect to any internal structure.
Symptoms of Fistula:
1. Swelling around or near the anus.
2. Skin irritation, redness and tenderness around or near the anus.
3. Anal pain and swelling.
4. Discharge of pus or blood from the area.
5. Fever due to infection and pus.
6. Constipation and painful bowel movement.
Causes of Fistula:
Fistula is very common in men between 20 to 40 years. Anal fistulas are very painful and uncomfortable because of the discharge of pus. Some common reasons which cause fistula include:
1. Infection in the anal glands.
3. Abscess in the large intestine
4. Crohn’s disease
5. Chronic Colitis
Diagnosis of Fistula:
A digital rectal examination is sufficient to diagnose an anal fistula but some patients require more tests to screen for:
1. Sexual infections
2. Inflammatory bowel diseases
3. Rectal cancer
4. Diverticular diseases
Doctors suggest tests such as ultrasound, a CT scan or an MRI to be conducted.
TREATMENT OF FISTULA:
Surgery is only the process to treat anal fistula. It is done under general anesthesia but sometimes regional anesthesia is also used. There are three surgical methods managing low level fistula.
1. Fistulectomy: This method is used for most distula cases. The tract is removed and sent for histopathological examination. It would takes around one or two months to heal by getting flattened into scars.
2. Laser Ablation: This procedure involves no cutting, no wounds, no need of dressing and patient’s life is back to normal by the following day. The doctor first identifies the tract and cleans it. A larger beam is induced into the tract to it.
3. Coring of fistula: A deep dissection is created around the fistula and the tract is then removed from the digestive tract. Seton Techniques: Seton is a piece of thread which is left in the fistula tract. This method is considered if the patient is at high risk of incontinence when the fistula crosses the sphincter muscles.
4. Advancement Flap Procedures: The procedure is considered usually when the fistula is complex or has a high risk of incontinence. The flap is a piece of tissue that is removed from the skin around the anus. During surgery, the fistula tract is removed and the flap is attached where the opening of the fistula was. This procedure is effective for about 70% of cases.
5. Fibrin Glue: This is only non-surgical treatment option. The glue is injected into the fistula to seal the tract, then the opening is stitched closed. This procedure is simple, safe and painless. However, it is not effective for long term results.
6. Bio prosthetic Plug: This cone shaped plug is made from the human tissue, which blocks, the internal opening of the fistula. However this does not completely seal the fistula, so that it can drain. To heal the fistula, a new tissue usually grows around the plug. The long term success rates of this method are uncertain.