ANAL FISTULA
Anal fistula is the formation of a small infected tunnel connecting the skin near the anus and the end of the bowel. It is very painful and can lead to bleeding and discharge during defecation. In some cases, the drainage can be persistent, while in other cases it is recurrent.
Causes
- Long-standing abscess
- Underlying medical conditions
- Tuberculosis
- Anal trauma
- Sexually transmitted diseases
Symptoms
- Anal bleeding
- Perianal swelling
- Pus or bloody discharge
- Pain during bowel movements
- Skin maceration
Anal Fistula Treatment
Treatment for fistula depends on certain factors such as the location of the fistula, presence of sepsis or large abscess and the findings of the physical examination. The goal is to completely repair the fistula and prevent its recurrence and to safeguard the sphincter muscles. Damage of the sphincter muscles can lead to uncontrolled bowel movements.
Usually, surgery is the best treatment for anal fistulas. The main surgical procedures include:
Fistulotomy: This procedure involves cutting open of the fistula which heals into a flat scar.During 17th century, where the state of medicine was very bad, Louis XIV, the Sun King of France had anal fistula and was treated by fistulotomy.
Seton procedure: This procedure involves insertion of a small surgical thread called seton, in the fistula to drain the infection. This helps in healing before carrying another treatment.
Ligation of intersphincteric fistula tract: This procedure is done in two stages and is to treat complex fistulas. Initially, a seton is placed in the fistula to widen it. After several weeks, the infected tissue is removed, and the fistula opening is closed.
Other techniques such as filling the fistula with special medical glue or covering it with a tissue or blocking it with a special plug may be performed. For more complex fistulas, techniques such as ostomy and stoma, or muscle flap are performed.
Discuss the benefits and the risks of every procedure with your surgeon about the procedures before undergoing one. Dr Vandana Bansal is one of the best fistula doctor in Indore. She has more than 27 years of experience in her field of surgery.