Anal Fistula : Causes and Symptoms
An anal fistula is an abnormal opening between the external skin of the buttocks and the anal canal. It occurs in around 30-40% of patients with an anal abscess.
An anal fistula develops when an anal abscess bursts before it is treated or is not entirely cured. An anal abscess is a painful pus-filled lesion caused by a bacterial infection in the tissues surrounding the anus.
What are the Types of Anal Fistula?
An anal fistula types can be categorised into the following types of depending on its location:
- Suprasphincteric Fistula: Located above the anal sphincter muscles
- Transphincteric Fistula (Horseshoe Fistula): A fistula that passes through the anal sphincter muscles
- Intersphincteric Fistula: Occurs between the internal and external sphincter muscles
- Extrasphincteric Fistula: Located outside the anal sphincter muscles
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Get A Second OpinionWhat are the Symptoms of Anal Fistula?
An anal fistula can cause the following symptoms:
- Irritation of the skin surrounding the anus
- Excruciating pain while sitting, moving and passing stool
- An unpleasant discharge from the anus
- Pus or blood in the poop
- Swelling and redness around the anus, as well as fever if you have an abscess.
- Controlling bowel movements may be difficult in some instances.
- The end of the fistula may be visible as a hole in the skin around the anus; however, patients may be unable to see it.
When to see a doctor?
If there are persistent anal fistula symptoms, talk to the primary healthcare provider immediately. Suppose the doctor thinks you might have a fistula. In that case, they can refer you to a specialist for further tests to confirm the diagnosis and determine the most suitable treatment.
What are the Causes of Anal Fistula?
One of the most common anal fistula causes is an anal abscess that fails to heal completely even after the absence of pus. Other factors include:
- Crohn’s Disease: Crohn’s Disease causes inflammation of the intestines and is the main cause of anal fistula.
- Diverticulitis: Diverticulitis is another cause of anal fistula. Swelling and infection in one or more diverticula leads to fever, nausea, etc.
- Hidradenitis Suppurativa: Hidradenitis suppurativa is a skin condition that leads to scarring and abscesses. It leads to the formation of an anal abscess.
- Other factors: Sexually transmitted infections (like syphilis and chlamydia), diabetes, radiation therapy, and smoking can increase the risk.
What are the Risk factors of Anal Fistula?
If an anal abscess develops, the chance of anal fistula formation. The following are some risk factors for developing an anal fistula:
- Syphilis and Chlamydia
- Radiation therapy
- Diabetes
- Dermatosis
- Excessive spicy food intake
- Smoking
- Tuberculosis
- Sedentary lifestyle
- Hyperlipidemia
- HIV Aids
- Alcohol consumption
Prevention of Anal Fistula
While not all cases of anal fistula can be prevented, these tips may reduce the risk:
- Maintain good hygiene around the anal area
- Avoid straining during bowel movements by consuming a high-fiber diet
- Treat infections or abscesses early to prevent fistulas from forming
- Practice safe sex to reduce the risk of sexually transmitted infections
How to Diagnose Anal Fistula?
The anal fistula diagnosis includes:
Diagnosing an anal fistula involves several steps to accurately assess the condition:
- Physical Examination: Doctors will check for visible openings, pain, or pus around the anus. Gentle pressure helps identify signs like blood or discharge
- Rectal Examination: A doctor may insert a gloved finger into the anus to check the fistula’s depth, the condition of the sphincter muscles, and the area of infection.
- Proctoscopy: A specialized scope is used to examine the rectum for internal fistula openings, often done under general anesthesia.
- Anal Endosonography (Anal Ultrasound): This test uses sound waves to capture images of the anal canal to assess the fistula's extent.
- MRI Scan: For more complex or recurring fistulas, an MRI or Magnetic Resonance Imaging Scan may provide detailed images of the affected area.
- CT Scan: A CT or Computerised Tomography Scan may be used to get detailed cross-sectional images of the body, helping to detect inflammation and other issues.
What is the Treatment of Anal Fistula?
The strength and complexities of the sphincter muscles are used to anal fistula treatment. However, no medications are available to treat this condition; the following surgical procedures must be performed:
- Fistulotomy This is the most common and effective surgical operation used to drain and open an anal fistula.
- Seton Techniques This procedure involves inserting the surgical thread into the fistula tract, allowing it to drain and heal entirely.
- Advancement Flap Procedure If the fistula passes through the anal sphincter muscles, this procedure is used to cover the hole and allow the fistula to heal.
- Fibrin Glue of Collagen Plug This is a non-surgical method in which the surgeon injects a special glue while under general anaesthesia. This closes the fistula and initiates healing.
- Anal Fistula Surgery Depending on the complexity, surgery may be necessary to completely heal the fistula and restore normal function.
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Book an AppointmentDo’s and Don’ts of Anal Fistula:
Bowel movements are related to food intake. The doctor always advises patients to adjust their diet if they have gastrointestinal diseases or conditions such as piles, fistula, fissures, etc. This aids in the relief of symptoms and the facilitation of smooth bowel motions.
What's more essential is to avoid foods that may aggravate the illness. The concern with anal fistula may reoccur with minor dietary and lifestyle changes. Following a good diet and healthy lifestyle practices ensure that the rectal fistula heals faster.
|
Do’s |
Don’ts |
|
Wear a pad over the anal area until healing is complete. |
Take any over-the-counter medicines without consulting the doctor. |
|
Avoid spicy and oily foods, |
Eat salty foods |
|
Eat a diet high in fiber and drink plenty of fluids. |
Drink caffeinated beverages |
|
Use a stool softener if needed |
Eat bakery items such as pastries, foods made of refined flour, hydrogenated oils, etc. |
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Eat a balanced diet to maintain bowel movements. |
Use harsh soaps in the affected region. |
Apart from these dos and don’ts, one should eat on time, avoid big meals, and drink enough water. However, if the problem persists with severe pain or discomfort, visit your doctor for the finest fistula therapy.
Anal Fistula Care at Medicover Hospitals:
At Medicover Hospitals, we have the best team of general surgeons and other specialists who treat anal fistula and its severe symptoms. Our highly trained doctors use the most up-to-date diagnostic tools and procedures to perform various medical tests, and treat patients.
Our medical experts collaborate closely with patients to evaluate their health and treatment progress to achieve a faster and more lasting recovery.
Frequently Asked Questions
What is an anal fistula?
An anal fistula is an abnormal tunnel-like passage that forms between the inside of the skin around the anus, often known as the rectum. It typically develops as a result of an infection or abscess near the anus.
What causes an anal fistula?
Most anal fistulas come on by infections that start inside the anal gland, which then leads to an abscess. The abscess can cause tissue to break down, creating a pathway for the fistula to develop.
What are the common symptoms of an anal fistula?
Anal fistula symptoms may include discomfort, swelling, redness, discharge of pus or blood, itching, and discomfort while sitting or during bowel movements.
How is an anal fistula diagnosed?
Normally, a doctor will do a physical examination of the affected area to diagnose an anal fistula. Sometimes, additional tests like an MRI or a fistulogram may be recommended to assess the extent and location of the fistula.
Is surgery the only treatment option for anal fistulas?
Surgery is often the main treatment for anal fistulas, especially when they are causing symptoms. Surgery aims to remove the fistula and any associated abscess or infection. In some cases, a seton (a small piece of surgical thread) may be placed to help drain the fistula and prevent recurrence.
What is the recovery process after anal fistula surgery?
Recovery after anal fistula surgery can vary, but it generally involves keeping the area clean, taking prescribed medications, and avoiding activities that might strain the surgical site. Follow your doctor's post-operative instructions closely for the best outcome.
When should I see a doctor for an anal fistula?
If you experience persistent pain, swelling, discharge, or discomfort around the anus, it's recommended to consult a medical professional. Early diagnosis and treatment can prevent complications and improve your quality of life.
