Anal Fistula Causes, Symptoms, Diagnosis & Treatment

An anal fistula refers to a small tunnel connecting an infected gland within the anus to a opening in the skin around it. The symptoms include swelling and pain around the anus. Treatment and diagnosis are discussed.

What is an anal fistula and how can it be treated?

An anal fistula, a small, infected tunnel, connects to an abscess in the anus and an opening in the skin around it.

The anus is the opening that allows feces to be expelled from the body. A number of tiny glands make mucus just inside the anus. These glands can sometimes become clogged, which can lead to an abscess. A fistula may form in about half of these abscesses.

SYMPTOMS & CAUSES

What causes anal fistula?

Anal fistula is most commonly caused by clogged anal glands or anal abscesses. Anal fistula can also be caused by other conditions, which are less common.

Crohn's disease is an inflammatory disease of your intestine.

Radiation (treatment of cancer)

Trauma

Sexually transmitted diseases

Tuberculosis

Diverticulitis is a condition in which small pouches develop in the large intestinal tract and become inflamed.

Cancer

Also Read: Anal abscess and anal fistula

What are the signs of anal fistula?

Anal fistula can be characterized by the following symptoms:

• Frequent anal abscesses
• Anus pain and swelling
• An opening around the anus can cause bloody or foul-smelling drainage (pus). After the fistula drains, the pain might decrease.
• Drainage can cause irritation of the skin around your anus.
• Bowel movements and pain
• Bleeding
• Feelings of fatigue, fever, and chills

If you have any of these symptoms, it is important to see your Fistula doctor in Kolkata immediately.

DIAGNOSIS AND TEST

How can an anal fistula be diagnosed?

An anal fistula can be diagnosed by your Fistula Specialist Doctor by looking at the anus. The doctor will examine the skin for a fistula tract (or an opening). The doctor will determine the depth of the tract and its direction. There will likely be drainage from an external opening in many cases.

Some fistulas might not be obvious on the skin's surface. Your physician may have to run additional tests in this instance.

Anoscopy refers to a procedure that uses a special instrument to view inside your anus or rectum.

To get a better look at the fistula tract, your doctor may order an ultrasound or MRI.

Your surgeon may need to perform an exam under general anesthesia to diagnose fistula.

Your Fistula doctor may order further tests if a fistula is discovered. This is to determine if Crohn's disease is the cause. Fistulas are a common symptom of Crohn's disease. These studies include blood tests, Xrays, and colonoscopy. The anus is used to insert a flexible, light-emitting instrument into the colon. This procedure is done under conscious sedation.

MANAGEMENT & TREATMENT

What are the treatment options for anal fistula?

Anal fistula can almost always be treated with surgery. A colon and rectal surgeon perform the surgery. The surgery aims to achieve a balance between removing the fistula and protecting the muscles of the anal sphincter, which can cause incontinence if they are damaged.

Fistulotomy is used to treat fistulas that have no or very little sphincter muscles. This procedure involves removing the skin and muscle covering the tunnel. It transforms it from a tunnel into an open groove. This allows the fistula tract's bottom to heal.

A surgeon might have to place a seton (a special drain) in the case of more complicated fistulas. This drain is usually left in place for at most 6 weeks. A second operation almost always follows the placement of a seton.

A flap advancement procedure: The fistula is covered using a flap or piece of tissue taken from the rectum. This acts as a trap door.

A lift is when the skin above the fistula has been opened up and the sphincter muscles have been spread. The fistula then is tied off.

Injecting stem cells into Crohn's disease fistulas can be a new treatment. Before you have the surgery, your colorectal surgeon can discuss all options.

Fistula surgery can usually be done outpatient, meaning that the patient can return home within 24 hours. Patients with very large or complex fistula tunnels might need to remain in hospital for a few days. Some fistulas require multiple operations to remove.

Is there any follow-up treatment for an anal fistula?

Surgery is a good option for most fistulas. Your surgeon might recommend that you soak your fistula in a warm bath (known as a sitz bathtub) and that you use stool softeners or laxatives for at least a week.

Your doctor may recommend pain pills or local anesthetics to reduce discomfort and pain after surgery. Opioids are often prescribed for a short time.

They will not return if the fistula and abscess are properly treated and healed.