How is an anal fistula treated and what is it?
A fistula is a small opening in the body that connects one organ to another. Adults with Crohn's disease are more likely than others to develop fistulas. In fact, a fistula will develop in between 35 and 50 percent of adults with Crohn's disease at some point.
There are many different kinds of fistulas that are linked to Crohn's disease. We discuss the most important characteristics of anal fistulas and their treatment.
An anal fistula is what?
There are a few different types of fistulas that are associated with Crohn's disease, but the anal or perianal fistula is the most common one. A fistula around the anus is referred to as a "peri," which means "around." When the anal canal or rectum connects to the surface of the skin close to the anus, this is known as an anal or perianal fistula. An infection or abscess that did not heal properly frequently results in these fistulas.
The following are some obvious signs that you may have an anal fistula:
a tender lump or swelling in the area around the anus frequent anal abscesses pain and irritation that gets worse when you sit down, move, urinate, or cough bloody stool or pus that smells bad from an opening around the anus painful bowel movements They might direct you to a Fistula doctor in Kolkata who specializes in diseases of the colon and rectal. The doctor will look for a fistula opening near your anal opening during your physical exam. They might apply pressure to the area to see if pus comes out, and they might also try to figure out how deep the tract is and where it is going.
To confirm the diagnosis of an anal fistula, your Fistula doctor may also conduct the following tests:
Fingernail probe: A long, slight test that is directed through the external opening of the fistula.
Anoscope: a special scope that examines the anus and rectum inside the body.
An MRI or a CT scan: Special magnets and a computer are used in an MRI to create images of the area. Using sound waves, an ultrasound produces an image of the anal region.
Other Crohn's connected fistulas incorporate entrail to bladder; intestine to vagina; intestine to skin; also from bowel to bowel.
Anal fistula treatment options typically call for a combination of medication and surgery.
Also Read: Home Remedies for Anal Fistula
Fistulas rarely heal completely with medication, but your Fistula Specialist doctor may prescribe the following:
Your fistula may feel more comfortable and discharge may be reduced with antibiotics. A course of antibiotics may not be effective for anywhere from six to eight weeks. Treatment may be continued for a few months in some cases. However, antibiotics rarely result in lasting and complete healing.
It has been demonstrated that biologics can heal perianal fistulas and maintain their healing. After any abscesses have been treated with antibiotics, these are typically initiated.
One in three people with Crohn's disease who have an anal fistula will require surgery at some point. An anal fistula can almost always be fully treated with surgery. The objective is to eliminate the fistula while safeguarding the muscles of the anal sphincter, which regulate the release of bowel movements. For patients who have an anal fistula, the most common surgical options are as follows:
Fistulotomy: For many patients with anal fistula, this is the most common and most effective treatment. The length of the fistula is cut open during this procedure. The fistula can heal from the inside out thanks to this procedure's opening. Most of the time, it is done outside of a hospital. It can take anywhere from a week to several months to heal.
Flap for advancement: When cutting the fistula tract open would pose a high risk of incontinence, this method is utilized for more complicated fistulas involving the sphincter muscles. A flap, or piece of tissue taken from the rectum, is used to cover the fistula after the tract of the fistula has been cleaned while keeping the sphincter muscles intact.
LIFT stands for "Ligation of the Intersphincteric Fistula Trap." The sphincter muscle will not be cut during this procedure. A small cut will be made by the surgeon at the anal canal's entrance. After the surgeon locates the fistula tunnel that runs between the internal and external muscles of the anal sphincter, it is divided in half. The ends are then sealed with a stitch.
Surgery works well for most patients. Your doctor may advise you to take stool softeners or laxatives as needed, soak the affected area in a warm bath, drink plenty of fluids, wear a pad over your anal area, and soak the area in a warm bath after the surgery. Complex anal fistulas can be treated with other experimental treatments. Discuss the best course of action for your particular situation with your doctor.
Adults with Crohn's disease are wanted by researchers for clinical studies. Patients with Crohn's disease who have had anal fistulas in the past can aid in research. In the future, your participation might even lead to new treatments. Below, you can begin your search for a clinical trial.
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