The anus is a part of the human body where the faecal material or waste material is excreted. Now when a tunnel of epithelialized tissue is formed between the skin and the digestive tract’s muscular opening (anus), the medical condition is known anal fistula. The infected area appears as an abscess and is filled with pus that has a foul smell. The pus oozes out from the tunnel in severe fistula conditions.
In 50% of cases, an anal fistula can recur, which means it can be caused due to the result of the previous fistula. At Smiles Gastroenterology, we provide the best fistula treatment in Bangalore. The fistula specialists in Bangalore at Smiles Gastroenterology has a 3% recurrence rate, which is the lowest in the domain. Depending on the severity of the fistula, you can also get a fistula treatment without surgery in Bangalore at our centre. However, if you need surgical treatment, Smiles Gastroenterology offers the best treatment for fistula, which includes laser treatment. To know the fistula laser treatment cost, you can reach out to us.
It has been found that anal fistula is caused due to infection in the digestive tract and acute infections in the anus. The infection is drained through medical treatments, mostly surgery, to remove the abscess.
An anal fistula can be classified based on the region where it occurs; the part surrounding the anus and its relationship with the sphincter muscles. Sphincters muscles are those muscles that regulate the movement of stools. Only a fistula specialist in Bangalore at Smiles Gastroenterology can diagnose and recommend the right treatment, depending on the region it occurs.
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What are the Different Types of Anal Fistula?
- ● Perianal fistula – It is the most common type that occurs between the skin and anus.
- ● Intersphincteric fistula – The tunnel (fistula) starts between the internal and external sphincter muscles and opens to the anus.
- ● Transsphincteric fistula – Also known as horseshoe fistula, this is a type that starts between the inner and outer layer of the sphincter muscle, crosses the external muscle, and opens an inch or two before the anus.
- ● Extrasphincteruc fistula – This is among the least occurring of all the types of anal fistula. It begins at the rectum and has an exit around the anus.
What Causes Anal Fistula?
- ● Crohn’s disease – It is a condition that causes inflammatory bowel disease. Crohn’s disease stays lifelong, where the digestive system becomes inflamed. The symptoms include diarrhea, stomach cramps, loss of weight, etc. Oral treatment for reducing inflammation can relieve the pain, but surgery is a better treatment option above all.
- ● Tuberculosis or sexually transmitted disorder like HIV causes anal fistula.
- ● Diverticulitis – The condition where small pouches of the digestive tract sell and protrude out from the sides of the colon. Sharp pain in the stomach, fever, chills, nausea, are common symptoms that are observed.
- ● Any complicated surgery surrounding the anus can cause an anal fistula.
What Are the Symptoms of Anal Fistula ?
- ● Irritation around the anus.
- ● Consistent pain that worsens when you sit down, move, cough, or during the passing of stool.
- ● Foul-smelling discharge from the pus found around the abscess.
- ● While exciting blood passes with the stool.
- ● Inflammation around the anus that turns red.
- ● Increase in body temperature due to the swelling.
- ● Loose motion in some cases or bowel incontinence.
- ● Painful urination.
How is Anal Fistula Diagnosed?
- ● Physical examination of the rectum is performed to look for any swelling, or oozing fluid.
- ● MRI and CT Scan – These scanning procedures give a digital image of the internal part of the anus, which is not visible to the naked eye.
- ● Colonoscopy – For this test, you will be given anaesthesia, and the procedure is performed after that. A tube having a camera on one end is moved inside the anus to get a clear look at the bowel.
How is Anal Fistula Treated?
- ● Fistulotomy – The track or fistula is cut and left open to heal by drying. This procedure is carried out when the fistula is present straight and not in a U shape. During the surgery, a groove is made that heals from the inside when left open. The success percentage of fistulotomy is approximately 97%.
- ● Seton surgery – Seton is a surgical thread which the surgeon inserts inside the fistula and leaves it there for weeks to keep the fistula open. During this time, excess fluid drains out from the tunnel and slowly starts drying. The procedure goes on for 6 weeks.
- ● Flap procedure – When the fistula’s location is linked with the sphincter muscle, normal surgery cannot be performed and can cause a persistent leak from the hole formed during surgery. For the flap surgery, a layer of tissue is cut from the rectum and attached at the fistula’s opening after it is removed. The process tends to be 70% effective.
- ● LIFT procedure – The abbreviation stands for Ligation of intersphincteric Fistula Tract. During the surgery, a cut is made in the skin present above the fistula, and the sphincter muscles are moved. Both the fistula ends are stitched together and then cut open to make it a flat scar.
- ● Bioprosthetic plug – It is also an advanced surgery. A cone-shaped plug is made out of the animal tissue and inserted inside the fistula to block its opening. The process avoids any further leakage from the opening.
- ● Non-surgical method – It is the only non-surgical option for the treatment of anal fistula. In the process, fibrin glue is injected into the fistula. This glue seals the opening and helps in healing. The process can be performed when fistulotomy is not long-lasting.
Result – The result of anal fistula treatments are mostly successful without further medical issues.
What Are the Risks Involved During the Surgery?
- ● Recurrence of the fistula – This is often seen in anal surgery when the fistula regrows even after the removal.
- ● Infection – After the surgery, antibiotics are given to avoid infection chances, and the patient needs to be kept under observation for a few days to treat the infection in case of emergency..
- ● Bowel incontinence – The loss of control over bowel movement is one of the potential risks seen after anal fistula surgery. The stool may pass with gas or urine and cause a complete lack of control.
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Pregnancy & Fistula
What Is Pregnancy & Fistula?
During prolonged labour, the contractions push the head of the baby against the mother’s pelvis. When the soft tissues in between get compressed, the normal flow of the blood is restricted. Without sufficient blood, some tissues could either get damaged or die, leaving holes, which in medical terms is knowns as fistulae. In addition, if it is not treated in time, the woman might experience a leak of stool, urine, or both for the lifetime.
Obstetric fistula is a threatening condition, and the woman might have to suffer excruciating pain for quite a few days. And in the worst scenarios, she might even lose her baby.
What Causes Fistula in Pregnancy
- When a woman gets pregnant at a pretty young age, there could be a risk of occurrence of fistula.
- If the woman is thin and lean because of malnutrition, she might face a complex delivery due to small pelvic bones.
- When there is no proper medical facility, and if C-section cannot be performed on time, the woman must undergo prolonged labour, leading to fistula. It usually happens in underdeveloped countries.
- The constant pushing of the baby through the pelvis could stop the blood supply and create fistulas.
What Are the Symptoms of Pregnancy & Fistula?
- Uncontrollable leakage of blood, urine, faeces and blood
- Continuous dripping could cause severe wounds due to the acid in the leakage.
Effects of fistula
Some of the severe effects, if the fistula is not medically treated in time, would be:
- Skin damage or ulceration, usually near and around the genitals.
- Death of baby
- Besides physical effects, a woman might also go into depression, and it could get complicated for her to come back to everyday life.
How is Pregnancy & Fistula?
Besides the surgery, the woman would also need psychological treatment as she has gone through a traumatic situation. In addition, regular counselling, proper care, and monitoring of her health are also required.