Anal fistula ( Fistula in ano)

Background 

Anal fistula is usually described as tunnel  (tract), which connects an infected gland (abscess) inside the anus to an opening on the skin. The skin glands present around anal areas might get blocked which leads to infection. Such infection leads to abscess and most of them turn into fistula. 

The symptoms of this condition may bother patients while carrying regular activities which might hamper there routine activities. 

Symptoms of anal fistula 

Fistula in anal can be painful and irritating, signs and symptoms of it includes:

  • Frequent abscesses in anus
  • Redness
  • Pain around the anus
  • Swelling around the anus
  • Smelling or bloody pus from an opening around the anus. 
  • Irritation around the anus from drainage of abscess
  • Occasional painful bowel movements
  • Bleeding
  • Fever 

Causes:

The blockage of some glands inside the anus, which makes fluid are the top most causes of anal fistula. When such blockage happens, the bacterias create an abscess (a swollen pocket of infected tissue). The abscess grows if the condition remains untreated. This growth may  become visible near the anus and can cause fistula. However, it rarely happens. 

There are some other conditions as well, which can cause fistula including:

  • Sexually transmitted diseases (STDs)
  • Diabetes 
  • Cancer
  • Tuberculosis
  • Crohn’s disease 
  • Diverticulitis 
  • Immunosuppressed patients 

Diagnosis and investigations 

These symptoms are very irritating and should not ignored for long time. It’s wise to consult with your surgeon for examination and investigations. Anal fistula is a clinical diagnosis and surgeons usually advice to undergo Routine blood investigations and magnetic resonance imaging ( MRI) of the pelvis to exactly determine the length and location of fistula tract. 

Treatment:

The standard treatment for anal fistula is surgery. Medications can provide temporary relief to the symptoms. There are various technical procedures performed to cure the disease. 

The preference of the procedure depends upon the size, length and location of the fistula. The common procedures performed are fistulectomy, fistulotomy, fistulectomy with seton placement, Laser fistulectomy , Ligation of internal fistula tract( LIFT procedure)  and  Video assisted anal fistula treatment ( VAAFT). These procedures can be performed as stand alone techniques or in combined techniques to achieve  complete cure. 

Recovery after surgery 

The patients are usually discharged in 1-2 days from the hospital. The surgeon will advice you to take medications after discharge. Fistulas are known  for notorious recurrence so it’s important to follow the preventive measures advised by your surgeon to prevent recurrence. 

To know more, consult our best team of General and minimal access surgeons at  Surgeons House Limited (SHL) available at different global locations. Please click this link for more details. 

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