Amoebiasis, also known as amoebic dysentery, is an infectious disease caused by the parasite Entamoeba histolytica. It primarily affects the intestines but can also spread to other organs like the liver.

How is amoebiasis transmitted?

Amoebiasis is typically transmitted through the ingestion of food or water contaminated with the cysts of the Entamoeba histolytica parasite. Additionally, it can spread by coming into contact with faeces directly.

What are the symptoms of amoebiasis?

Symptoms of amoebiasis include diarrhea, stomach pains, bloody stools, exhaustion, weight loss, and fever. In severe cases, the infection may result in liver abscesses.

How is amoebiasis diagnosed?

Diagnosis often involves analyzing stool samples for the presence of the parasite or its cysts. In some cases, imaging studies like ultrasound or CT scans may be used to detect complications like liver abscesses.

Is amoebiasis a common disease?

Amoebiasis is common in areas with poor sanitation and contaminated water supplies. Travellers to such regions are also at risk. However, not every infected individual experiences symptoms.

How is amoebiasis treated?

Amoebiasis is usually treated with medications that target the parasite, such as metronidazole or tinidazole. Severe cases with complications like liver abscesses may require additional interventions.

Can amoebiasis be prevented?

Yes, practicing good hygiene, washing hands before meals, consuming clean water, and avoiding food or drinks from unreliable sources can help prevent amoebiasis.

Can amoebiasis recur after treatment?

Recurrence is possible if the parasite isn't fully eliminated or if reinfection occurs. Completing the prescribed treatment and maintaining proper hygiene are crucial to preventing recurrence.

Is amoebiasis contagious?

Amoebiasis itself is not highly contagious. However, the parasite can spread through contaminated hands, food, or water, particularly in places with inadequate sanitation.

When should I seek medical attention for amoebiasis symptoms?

If you experience persistent symptoms like diarrhea, abdominal pain, and bloody stools, especially after traveling to regions with poor sanitation, it's advisable to seek medical attention promptly.

What is Anal Fistula?

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.

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What are the Types of Anal Fistula?

An anal fistula can be categorised into the following types depending on its location:

A Suprasphincteric Fistula
Transphincteric Fistula, or Horseshow Fistula
An Intersphincteric Fistula
An Extrasphincteric Fistula

What 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 symptoms of an anal fistula, 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 causes of anal fistula is an anal abscess that fails to heal completely even after the absence of pus. Other factors include:

Crohn’s Disease causes inflammation of the intestines and is the main cause of anal fistula.
Diverticulitis is another cause of anal fistula. Swelling and infection in one or more diverticula leads to fever, nausea, etc.
Hidradenitis suppurativa is a skin condition that leads to scarring and abscesses. It leads to the formation of an anal abscess.

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

What is the Prevention of Anal Fistula?

Here are some tips to help you avoid an anal fistula:

Maintain good anal hygiene by keeping the anal area clean and dry.
Avoid straining during bowel movements by consuming a high-fibre diet and staying hydrated.
Treat any anal infections or abscesses promptly to prevent them from developing into fistulas.
Practice safe sex to reduce the risk of sexually transmitted infections that can lead to anal fistulas.
Avoid prolonged sitting, as it can increase pressure on the anal area and contribute to the development of fistulas.
Seek medical attention if you experience symptoms like persistent anal pain, swelling, or drainage, as these could indicate an underlying issue that needs to be addressed promptly.

How to Diagnosis Anal Fistula?

The anal fistula diagnosis includes:

Physical Examination: The doctors perform a physical exam to identify the opening of the fistula, pain, and pus draining from the anal area. The doctor uses gentle pressing around the fistula to determine the bloody discharge and pain. While finding the external opening of an anal fistula is simple, finding the internal space of a fistula can be difficult.

Fistula extension
Sphincter muscles functioning
Area of infection

Other diagnostic tests are Proctoscopy: Proctoscopy is the use of a specialised telescope equipped with a fistula probe to look within the rectum. Proctoscopy is often conducted under general anaesthesia.
Anal Endosonography or Anal Ultrasound: Anal Endosonography, often known as anal ultrasound test, uses high-frequency sound waves to capture pictures beneath the surface of the anal canal.
Don’t strain while passing stool: Do not strain while passing stools. Straining may increase the anal skin's problems and lead the fistula to worsen. It is also important to prevent spending long periods sitting on the toilet seat. The longer you sit on the toilet seat, the more likely you strain and exacerbate the bowel motions.
MRI Scan: The MRI or Magnetic Resonance Imaging Scan technique uses strong magnetic fields and radio waves to create detailed pictures of the organs. This procedure is typically used for recurring or complex fistulae.
CT Scan: The CT or Computerised Tomography Scan technique incorporates X-rays, and computers can create detailed cross-sectional body pictures. This approach also helps accurately detect the level of inflammation.

What is the Treatment of Anal Fistula?

The strength and complexities of the sphincter muscles are used to treat anal fistulas. 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.

Do’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.
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.

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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.

Citations

https://www.nhs.uk/conditions/anal-fistula/treatment/

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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.