Fistula

An anal fistula is an external opening results in leakage of pus and bleeding. In short, an anal fistula is a small channel which can be developed between the end of the bowel and the skin near the anus. This is common among the people having the past history of an anal abscess (infected cavity filled with pus). Fistula occurred when abscess not drained and healed properly. A severe type of Anal fistula may result in pain, bleeding, drainage, and discomfort while sitting and doing bowel movements.

An anal fistula is also called “fistula-in-ano” which is a common problem nowadays. It is referred to as the abnormal connection between the inner surface of the anal canal and skin around the anal verge.

Causes Of Fistula:

Inside our anus, some glands are there which make fluids and which may get blocked or clogged. This may lead to raising a bacteria sweeping the pocket, infecting tissue and liquid which is called abscess. If this abscess is not treated, it may become fistula causing pain and bleeding.

Some of the common and rare causes of an anal fistula are:-

• Sexually Transmitted Disease
• Radiation (therapy for disease)
• Injury
• Diverticulitis (a sickness where little pockets structure in the internal organ and become aroused)
• Ongoing Illness
• Tuberculosis
• Crohn’s Disease
• Trauma
• Rectal Cancer
• Diverticulitis
• Immune deficiencies such as AIDS & HIV
• Growth of Ulcer
• Surgery Complications
• Syphilis

Symptoms of Anal Fistulas:-

As per the medical research and feedback from the patients, some of the common symptoms are:-

• Pain (while sitting and bowel movements)
• Incessant butt-centric abscesses
• Agony and enlarging around the butt
• Wicked or putrid seepage (discharge) from an opening around the rear-end. The aggravation might diminish later the fistula channels.
• Redness & Irritation
• Swelling around the anus
• Painful urination
• Bleeding
• Torment with defecations
• Fever, chills, and fatigue
• A Foul smelling liquid coming from abscess hole
• Recurrent anal abscess

Once you find the above symptoms, contact the Anal Fistula Doctor in Gurgaon immediately to get the timely treatment.

How to Diagnose the Anal Fistula?

The physician will check for your medical history and will evaluate it with a physical examination. The person in question will search for an opening (the fistula lot) on the skin. The specialist will then, at that point, attempt to decide how profound the parcel is, and the bearing where it is heading. Much of the time, there will be seepage from the outside opening. If fistulas are visible, they may be traced easily but for the invisible fistulas, some tests are required.

• X-Rays or Fistulography
• CT Scan
• Colonoscopy
• Anoscopy
• Endoscopic Ultrasound
• MRI
• Blood Test
• An injected dye solution
• Fistula Probe

Different Test for Fistula

An Anoscopy is a technique where an extraordinary instrument is utilized to see inside your butt and rectum.

Your doctor may likewise arrange an Ultrasound or MRI of the butt-centric region to improve perspective on the fistula parcel.

At times your specialist should look at you in the working room (called test under sedation) to analyze the fistula. Assuming that a fistula is found, your doctor may likewise need to do additional tests to check whether the condition is identified with Crohn’s infection, a fiery illness of the digestive system. Around 25% of individuals with Crohn’s infection foster fistulas. Among these investigations are blood tests, X-beams, and colonoscopy. A colonoscopy is a method where an adaptable, lit instrument is embedded into the colon by means of the rear-end. It is performed under cognizant sedation, a sort of light sedative.

A single or group of diagnostic tests can be performed using anaesthesia as and when required.

Medicines for Fistula:

The medical procedure is quite often important to fix a butt-centric fistula. The medical procedure is performed by a colon and rectal specialist. The objective of the medical procedure is harmony between disposing of the fistula while securing the butt-centric sphincter muscles, which could cause incontinence whenever harmed.

Fistulas in which there is no or little sphincter muscle included are treated with a fistulotomy. In this technique, the skin and muscle over the passage are sliced open to change it from a passage over to an open section. This permits the fistula lot to recuperate from the base up.

On account of a more perplexing fistula, the specialist might need to put a unique channel called a seton, which stays set up for something like a month and a half. Later a seton is set, a subsequent activity is quite often performed:

A headway fold method (the fistula is covered with a fold, or piece of tissue, taken from the rectum, similar to a hidden entryway), or

A lift methodology (the skin over the fistula is opened up, the sphincter muscles are spread, and the fistula is tied off).

Another treatment for Crohn’s infection fistulas is to infuse undifferentiated cells into the fistula. Your colorectal specialist will talk about each of your choices before the medical procedure.

Fistula medical procedure is typically done on a short-term premise, which implies the patient can return home that very day. Patients who have exceptionally enormous or profound fistula passages might need to remain in the clinic for a brief time frame later in the medical procedure. A few fistulas might require a few activities to dispose of fistula.

Surgical & Non-Surgical Treatments of Anal Fistula:

For the simple fistula, you are not required to stay in hospital as some medications are enough to treat the fistula.

The most common fistula treatments are:-

Fistulotomy:

It is done to treat the crucial anal fistula. the doctor may cut open the skin and muscle surrounding the tunnel, to allow healing the inside out by flushing out the infected pus or tissue. Some glands may be required to remove from the channel by surgery. Once it is done, channels are flattened and stitched.

Seton Placement:

Seton or latex string is placed into the fistula to help drain the access or infected area. It may take up to 6 weeks to heal.

Advanced Rectal Flap:

It is used rarely. The surgeon will create a flap from the rectal wall. Ice the fistula removal surgery is done, the flap will be used to cover the repair. The procedure reduces the amount of sphincter muscle that is cut.

Fibrin Glue and Collagen Plug:

Once the surgeon will clear the channel and stitches the internal opening, the external opening can be sealed using a plug of Collagen protein. Special glue (fibrin) made of fibrous protein can be injected through the external opening.

Ligation of the intersphincteric fistula tract (LIFT):

It’s a two-stage treatment in which Seton is placed into the fistula tract to help drain the abscess. After several weeks, the surgeon will remove the infected tissue and will close the internal opening.

Ostomy and stoma:

This is done to teat the complex fistula which is more invasive. A temporary opening is created into the abdomen to divert waste into a collagen bag, and to allow the anal area to heal.

Muscle Flap:

The channel opening is filed with the muscle tissue taken from the thigh, labia or buttock.

Stapler Surgery:

To perform this, the fistula path is checked with an endoscope to check for the interns opening. Then the internal opening is closed with the help of a stapler and entire path is destroyed using electrocautery under direct telescopic vision. The procedure is performed under local anesthesia.

Laser Surgery

This is the non-invasive procedure which removes the abscess without creating pain and bleeding.

Benefits of Laser Treatment of Anal Fistula

Laser Surgery of Fistula has become popular nowadays due to its unique advantages and features. It can offer you multiple benefits which are mentioned below:-

• No regular follow-ups with the doctor
• No Cuts & Wounds
• Non-invasive procedure
• Daycare procedure
• No Diet restrictions
• Resume to normal routine from next day
• Pain procedure
• Less risk of infection
• No or very less bleeding
• High success rate
• Easy and fast recovery

Preparation before the Surgical Treatment for Fistula:

To prepare for the surgery, the surgeon will always explain to you what to do or what not to do. he may ask you to:-

• Quit Smoking to reduce the risk of chest infection & wound
• Using laxatives to empty the bowels.
• Not to eat or drink for 6 hours prior to the treatment
• Common Body tests such as BP, Heart rate & urine tests
• Wear Compression stockings to help prevent blood clots

Risks attached to Fistula Treatment:

Although there is no risk associated after the surgery if it performed well, still some risks may be attached depending upon the severity of the disease and Body immune system which can be:-

• Feeling sick & sore due to anaesthesia
• Excessive Bleeding
• Blood Clots in the Vein in the leg
• Anal Infection
• Fecal Incontinence
• Reoccurrence

Post Operating care for Fistula Surgical Treatment:

Fistula can be cured with the surgical and nonsurgical treatments but to reduce the chances of fistula or inflammation, preventive care tips to be followed:-

• Taking Sitz Bath
• Using Analgesics
• Stool Bulking Agents
• Intaking finer rich diets
• Avoid sitting for long periods in the Toilet
• Drinking Plenty of Water
• Not straining too much during a bowel movement
• Avoid heavy exercising

Avoid lifting heavy stuff