Anal Fistula’s Symptom and Treatment
Anal Fistula can be seen as the result of an abscess in the anal that is a painful pus-filled apex caused by an infection by bacteria that has spread to the surrounding regions of the anus. The majority of anal abscesses result from an inflammation of the anus’s internal glands. Anal fistula development can be observed in around 30% to 40% of patients suffering from an abscess in the anal. Furthermore, 80 percent of fistulas in the anal are the result of anal infections.
What exactly is Anal Fistula?
An anal fistula is described as an abnormal gap between the outer skin of the buttocks as well as the anal canal. An anal fistula can develop because of the rupture of an abscess in the anal area prior to treatment or isn’t fully healed.
Based on the site the fistula is located, it can be classified as one of the following categories or types which can be described according to:
An Intersphincteric Fistula
This is an unusual tract which starts between the internal and external muscles of the sphincter and ends in the anus region.
Transphincteric Fistula or Horseshow Fistula
It is an unusual inflamed tract which crosses the external sphincter. It then extends outside of the anal part.
A Suprasphincteric Fistula
The abnormal tract begins between the internal and external muscle space. It is located outside of the anus, and then crosses that muscle.
An Extrasphincteric Fistula
It’s an abnormal tract that starts at the rectum. It then opens around the anus, after passing through the muscles. It usually occurs due to Crohn’s disease or an appendiceal abscess.
The causes of anal Fistula
One of the most common causes of anal fistulas is the formation of an abscess in the anal region which does not heal completely until the pus is drained. But, other causes are:
Crohn’s Disease
This causes irritation of the intestines and is a major reason for anal fistula.
Diverticulitis
An additional cause of anal fistula could be an inflammatory or infectious disorder that results in the development of tiny pouches in the colon’s side, diversticulitis.
Hindradenitis Suppurativa
It is an inflammatory skin condition that can cause abscesses and scarring. This causes the formation of an abscess in the anal region.
Read More: Are it Hemorrhoids, Colon Cancer?
What are the signs and symptoms?
The most common signs of anal fistula are described below, which include:
- The skin irritation that occurs around the anus area
- The anus area is red and swollen.
- Anal pain which may get worse during coughing, walking, or sitting.
- Fatigue
- The fever is accompanied by chills.
- Odor of foul
- Pain during bowel movement
- A rectum that is bleeding
Are there risk factors for Anal Fistula?
If an abscess on the anal side occurs then the chance of developing anal fistula increases. The risk factors that increase the likelihood of developing anal fistula include the following:
- Diabetes
- Therapy with radiation (for rectal cancer)
- Smoking
- Dermatosis
- Consumption of excessively spicy foods
- Tuberculosis
- Hyperlipidemia
- A lifestyle that is sedentary
- HIV Aids
- Alcohol consumption
- Diseases that are sexually transmitted (Syphilis as well as Chlamydia)
Anal Fistula Diagnosis
A diagnosis is made by the doctor after going through medical histories as well as the signs and symptoms that the patient has.
1. Physical Exam
The Best Fistula doctor in Kolkata conducts an examination that focuses on the fistula’s opening tenderness and drainage of pus from the region. In order to determine the presence of blood and tenderness, doctors resort to gentle pressure on the fistula.
If finding the opening externally of anal fistula may be easy, locating the internal opening of a fistula could be a challenging job. Thus, a rectal examination is generally recommended to locate the opening inside.
2. Rectal Examination
Rectal examination is performed by a physician who inserts one’s finger inside the anus and then covering it with an ointment glove and lubricated gel, to establish the following:
The site of infection
The muscles of the sphincter function
Fistula extension
3. Other diagnostic tests
Other tests that are used to diagnose to determine the best fistula treatment include:
Proctoscopy
It is making use of specially designed telescope equipped with a fistula probes that allow for a view within the rectum. Proctoscopy is typically performed under general anaesthesia.
- Anal Endosonography or anal Ultrasound
- Anal Endosonography (also known as Anal Ultrasound procedure makes use of high-frequency sound waves that are used to capture images that are located below the surface of the canal. It is safe in comparison to other methods and tests that are conducted.
MRI is also known as Magnetic Imaging Scan
The technique that is used to create Magnetic resonance Imaging scan makes use of strong radio waves and magnetic fields that create high-quality images of organs. This method is usually used for recurrence or more complex fistulae.
CT also known as Computerized Tomography scan
A combination of X-Rays and computer are mixed in CT as well as Computerized Tomography Scan method for creating detailed cross-sectional images of the body. This technique also assists in determining the severity of inflammation.
Care for Anal Fistula
The treatment of anal fistula relies on the quality and the complexity of the sphincter muscle. There are no drugs readily available for treating the condition so surgery is required to be carried out. These include:
Fistulotomy
It is a highly effective and widely used surgical procedure used to open and drain the fistula in the anal.
Seton Techniques
This procedure is accomplished by inserting surgical thread into the fistula’s tube, which allows it to flow and fully heal.
Advancement Flap Procedure
If the fistula is able to pass through the sphincter muscles in the anal region, this procedure is carried out, which involves closing the fistula’s hole so that it can heal.
Fibrin Glue from Collagen Plug
It is a non-surgical procedure that involves injecting specific glue in the presence of an anaesthetic general. This helps to close the fistula, while also enhancing the process of healing.
What are the possible complications following surgery?
1. Infection
The most frequent complications that can occur after surgery is an infection could have devastating effects and can affect various organs. In some cases patients may require medical attention and hospitalization.
2. Bowel Incontinence
Incontinence of the bowel or faeces can be caused by injury to the muscles that control the anal sphincter. It causes an oesophageal leakage out of the rectum. The probability of this complications is determined by the location of the fistula and the type of surgery done.
3. Recurrence of anal Fistula
However, even after surgery, there is a chance of recurrences of anal fistula. The frequency of this recurrence is dependent on the degree of complexity and the type of surgery that is that was performed.
Preventing Anal Fistula
Certain steps can be made to stop anal fistula. A few of the steps that could aid in preventing anal fistula can be described below. Consumption of ample fluids:
- Consuming a fibre-rich diet
- Keep dry in the anal area
- Be careful not to strain while passing stool.
- Regular exercises
