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Understanding Anal Fistula: An Overview
Anal fistulas (फिस्टुला), also known as fistula-in-ano, are abnormal tunnels that form between the skin and the anus, often resulting from an infection or abscess. This condition occurs when a small gland inside the anus becomes infected, creating a tunnel that can cause pain, bleeding, and discharge. Anal fistulas can be classified based on their complexity and location relative to the anal sphincters.
Most commonly found in adults aged 30–50, anal fistulas require prompt medical attention. Comprehensive diagnosis and treatment are essential for effective management. Continue reading to learn more about anal fistulas, including symptoms, causes, types, diagnostic methods, prevention strategies, treatment options, and more.
Disease name: Anal Fistula
Symptoms:
Pain, Bleeding, Discharge, Discomfort during bowel movements
Causes:
Infection, Anal abscess, Crohn’s disease, Trauma
Diagnosis:
Physical examination, Imaging tests (MRI, CT scan), Anoscopy
Treated By:
Colorectal Surgeon, Gastroenterologist, General Surgeon (Proctologist)
Treatment Options:
Medications, Fistulotomy, Seton placement, Advancement flap, LIFT procedure, Fibrin glue
What are Anal Fistula?
Fistula in Ano, commonly known as an anal fistula, is an abnormal passage or tunnel that forms between the anal canal and the skin near the buttocks. The anus, the opening from which faeces are expelled, is connected to this tunnel, which has two openings: an internal one towards the anal canal and an external one on the skin.
Anal fistulas typically develop due to infections and pus collection in the anal glands, which drain and form a tunnel. They are often confused with piles or haemorrhoids. Fistulas can be classified as either simple or complex based on their structure.
Simple Fistula
- Usually caused by glandular obstruction leading to an abscess
- It consists of a single tract
- Easier to diagnose and treat
- Low recurrence rate and fewer complications
- Requires surgical treatment
Complex Fistula
- Recurrent with multiple tracts
- Often associated with underlying conditions like Crohn’s disease, inflammatory diseases of the rectum, or radiation therapy
- It is more challenging to treat due to its intricate nature
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Types of Anal Fistula
Anal fistulas are abnormal passages that connect the inside of the anus to the skin around it. These painful and often recurring conditions can vary in complexity.
There are primarily four types of anal fistulas:
- Intersphincteric Fistula: This is the most common type, located between the two layers of anal muscles.
- Transsphincteric Fistula: Extending through both layers of anal muscles, this type is often linked to infections spreading from an abscess.
- Suprasphincteric Fistula: Located above the internal anal muscle, it typically results from an infected abscess.
- Extrasphincteric Fistula: This rare type extends beyond the outer anal muscle and is usually caused by a chronic infection.
Symptoms of Anal Fistula
The symptoms of an anal fistula often follow a repetitive cycle and can vary in severity. The most common signs include:
- Persistent Pain and Discomfort: This is often felt during bowel movements or sitting.
- Itching and Irritation: The skin around the anus may become itchy and inflamed.
- Visible Opening: You may be able to feel or see a small opening near the anus.
- Recurring Anal Abscesses: These are painful, pus-filled lumps that can precede or accompany a fistula.
- Discharge: A foul-smelling, pus-like discharge may leak from the fistula.
- Bleeding: In some cases, bleeding may occur from the anus.
These symptoms indicate the need for medical evaluation and treatment. If you experience any of these signs, it is important to consult a healthcare specialist for proper diagnosis and management.
Causes of Anal Fistula
An anal fistula typically originates from an infected anal gland. When blocked, these glands can become breeding grounds for bacteria, leading to an inflamed, pus-filled abscess. This abscess often bursts or is surgically drained, leaving behind a tunnel-like passageway known as a fistula.
While most fistulas stem from this common cause, certain underlying conditions can also contribute to their development. These include:
- Inflammatory bowel diseases: Crohn’s disease and ulcerative colitis
- Infections: Tuberculosis, sexually transmitted infections
- Other factors: Trauma, anorectal cancer
These conditions can create circumstances that increase the risk of fistula formation.
Treatment Options for Anal Fistula
Anal fistulas typically require treatment to ensure complete healing. While surgery is often necessary, non-surgical methods and medications can also be considered based on the specific case. Here are the main treatment options:
Surgical Options:
- Fistulotomy: Common for simple fistulas, involves cutting the fistula to heal as a scar.
- Seton Techniques: A suture or band is used to aid healing in long or complex fistulas.
- Laser Surgery: Seals the fistula tract using laser heat.
- Advancement Flap: Closes the internal opening with tissue from the rectum or anus, used for fistulas through sphincter muscles.
- LIFT (Ligation of the Intersphincteric Fistula Tract): Ligates and removes the fistula for those involving the sphincter muscles.
Non-Surgical Option:
- Fibrin Glue: Injects a fibrous glue into the fistula to seal and promote healing.
Medications and Home Remedies:
- Pain Relief: Over-the-counter options as advised by a doctor.
- Diet: Eat fibrous foods, drink plenty of water, and avoid alcohol. Ginger tea and turmeric milk can help prevent constipation.
When to Consider Anal Fistula Surgery?
Surgery for anal fistulas is often considered in the following situations:
- Persistent Symptoms: If the fistula causes ongoing pain, discomfort, or drainage despite non-surgical treatments.
- Recurrent Fistulas: When the fistula returns after previous treatments or surgeries.
- Complex Fistulas: For fistulas that involve the anal sphincter muscles or have multiple tracts.
- Ineffective Medications: When medications and non-surgical options fail to resolve the condition.
- Impact on Quality of Life: When the fistula significantly affects daily activities and overall quality of life.
Cost of Anal Fistula Surgery
The cost of anal fistula surgery in India varies based on factors such as the type of procedure, the hospital or clinic, and the location. Below is a table outlining the approximate costs for different types of anal fistula surgery:
Fistulotomy
₹44,000 to ₹60,000*
Fistulectomy
₹55,000 to ₹75,000*
Fibrin Glue Treatment
₹23,000 to ₹35,000*
LIFT Procedure
₹65,000 to ₹90,000*
* T&C Apply
When to Consult a Doctor for Anal Fistula?
If you’re experiencing any of the following symptoms, it’s important to consult a doctor for an anal fistula:
- Persistent pain in the anal area.
- Noticeable swelling or lumps near the anus.
- Ongoing or recurrent discharge of pus or blood.
- Fever accompanying anal discomfort.
- Difficulty or pain during bowel movements.
- Unexplained, severe itching around the anus.
- Noticeable changes in bowel habits or stool consistency.
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Experience Relief with Anal Fistula Treatment from Cure Me Experts
Anal fistulas can be uncomfortable and distressing, but effective treatments are available to alleviate symptoms and enhance your quality of life. Persistent pain, swelling, and discharge are signs that require attention to prevent complications. While non-surgical treatments and medications can offer temporary relief, surgery is often necessary for a permanent solution. Advanced surgical techniques like fistulotomy, seton techniques, and laser surgery can address the issue effectively.
Taking proactive steps by recognising symptoms early and exploring treatment options with specialists at CureMe can lead to improved comfort and a more confident, fulfilling life.
