A fistula is a small tunnel that connects the infected gland inside the anus to an opening on the skin around the anus. They’re usually caused as a result of an infection near the anus causing a collection of pus (abscess) in the nearby tissue.
When the pus drains away, it can leave a small channel behind. Symptoms include pain and swelling around the anus and pain with bowel movements. Surgery is the only treatment option for anal fistula.
Causes of Fistula
Anal fistulas usually develop after an anal abscess. They occur when the abscess doesn’t heal properly after the pus has drained away. Approximately, one in every two to four people with an anal abscess will develop a fistula. Some diseases and infections can cause fistulas, such as:
Other causes of Anal Fistula include:
- Crohn’s disease –Inflamed digestive system, (a long-term condition)
- Diverticulitis – infection of the small pouches that stick out of the large intestine (colon)
- Hidradenitis suppurativa – skin condition causing abscesses and scarring
- Tuberculosis (TB) or HIV
- Sexually transmitted diseases
- A surgery complication near the anus
Symptoms and signs of Anal Fistula
- Skin irritation around the anus
- A constant pain which gets worse on sitting, during bowel movement or coughing
- Smelly discharge around your anus
- Blood or pus with stools
- Inflammation around your anus and fever, if you also have an abscess
- Bowel incontinence ( loss of bowel control)
- The end of the fistula that looks like a hole in the skin near your anus
- Physical exam
- Medical history
- Some fistula can be spotted easily, while others are not
- X-ray or CT Scan
- Colonoscopy ( a tube with a camera at its end is inserted into your anus to look at the inside of your bowels.
- She’ll probably send you to a specialist in colon and rectal problems for more exams or imaging tests like X-rays or a CT scan. You might even need a colonoscopy. For this test, the doctor will put a tube with a camera on the end into your anus to look at the inside of your bowels.
Treatment options for fistula:
Surgery is the only treatment option for fistula. The aim of surgery is to heal the fistula while avoiding damage to the sphincter muscles, the ring of muscles that open and close the anus, which could result in loss of bowel control. The best option will depend on the position of your fistula and whether it’s a single channel or branches off in different directions.
- Fistulotomy – This procedure involves cutting open the length of the fistula so it heals into a flat scar
- Seton procedures – A piece of a surgical thread called a seton is placed in the fistula and left there for several weeks to help it heal before a further procedure is carried out.
- LIFT procedure – The ligation of the inter-sphincteric fistula tract (LIFT) procedure is a relatively new treatment for anal fistulas.
- Other techniques – The fistula is filled with a special glue, blocked with a special plug, or covered with a flap of tissue.
When to seek medical advice?
If you have persistent symptoms of an anal fistula and have difficulty passing your bowels or on sitting while doing other activities, you must see a doctor. Your symptoms and other exams can confirm anal fistula. A thorough rectal examination can help diagnose and treat it with surgery by a colorectal surgeon.
Why Ravi Hospital?
Ravi hospital has senior and experienced doctors who have treated several hundreds of fistula with a surgery. The hospital is equipped with latest technologies, a 24-hour in-house laboratory, round-the-clock CT Scan, Critical Care, Intensive Care Unit, Emergency service and much more.
Have questions or need an appointment? Call Ravi Hospital.