Anal Fistula

Anal Fistula

Symptoms, Causes and Treatment
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A fistula-in-ano is an abnormal hollow tract or cavity that is lined with granulation tissue and that connects a primary opening inside the anal canal to a secondary opening in the perianal skin; secondary tracts may be multiple and can extend from the same primary opening.

What is Anal Fistula?

The anus is the external opening through which feces are expelled from the body. Just inside the anus are a number of small glands. If one of these glands become blocked, an abscess — an infected cavity — may form. An anal abscess is usually treated by surgical drainage, although some drain spontaneously. About 50% of these abscesses may develop into a fistula, in which a small tunnel connects the infected gland inside the anus to an opening on the skin around the anus.

Facts on anal fissures

Here are some key facts about anal fissures.
  • damage to the lining of the anus is a common cause
  • in some cases they are idiopathic (no known cause)
  • approximately 10 percent of people are affected in their lifetime
  • staying hydrated may help prevent anal fissures

Symptoms

The following may be symptoms or signs of an anal fistula:
  • Recurrent anal abscesses
  • Pain and swelling around the anus
  • Pain with bowel movements
  • Bleeding
  • Bloody or foul-smelling drainage (pus) from an opening around the anus
  • Irritation of the skin around the anus due to persistent drainage
  • Fever, chills, and a general feeling of fatigue

Causes

Most fistulas result from an anal abscess. A small number of fistulas may less frequently be caused by other processes such as

Trauma

Tuberculosis

Rectal Cancer

Diverticulitis

Sexually-transmitted infections

IBD & Crohn's disease

Treatments

Fistulotomy

This is used in 85-95% of cases and involves cutting open the whole length of the fistula in order for the surgeon to flush out the contents. This heals after one to two months into a flattened scar.

Seton techniques

A seton is a piece of thread which is left in the fistula tract. This may be considered if you are at high risk of developing incontinence when the fistula crosses the sphincter muscles.

Advancement flap procedure

This option is usually when the fistula is considered complex, or is there is a high risk of incontinence. The advancement flap is a piece of tissue that is removed from the rectum or from the skin around the anus. 

Consult doctor before going for any treatment

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