All about Anal Fistula and its treatment
An anal fistula is an abnormal cavity that runs from the skin and anus. An anal fistula is a result of an infection in the anal gland, due to which pus collects in the adjoining tissue. An anal fistula is also associated with conditions as Crohn’s disease. Further, patients have been diagnosed with an anal fistula after undergoing radiation therapy to treat cancer. In India, an anal fistula is common among those aged between 30 and 50.
The statistics show a prevalence of 2 in every 10,000 individuals in the population each year. Anal fistulas are far more common in men than women. Surgery and injuries on the anal canal can also cause anal fistulas. Such patients usually experience spontaneous draining of pus.
To correct an anal fistula, it may be necessary to undergo surgery. The surgeon surgically drains pus via the skin adjacent to the anus. A tunnel develops beneath the skin and it adjoins the anus with the infected gland. However, it is important that you consult with medical experts so that they can conduct a thorough examination and make a decision on the most appropriate mode of treatment. Feel free to schedule an appointment with our medical staff so that they can carefully assess your case and recommend the most appropriate mode of treatment. We offer a pocket-friendly package for treating anal fistula that includes consultation, treatment fees, post-op advice and care.
What are the possible causes of anal fistula?
Anal gland abscess
The main cause of an anal fistula is an abscess on the anal gland. This happens when an abscess has not healed properly after the pus drained out. An abscess forms as a result of the accumulation of bacteria, when associated glands get blocked or clogged. Such an abscess needs to be treated urgently. Otherwise, it develops outside and forms a tunnel in the skin adjacent to your anus.
An anal fistula may develop due to other less common causes. They include:
- Diverticulitis: This refers to an inflammation of the pouches found in your colon. The pouches so formed exert outward pressure on the walls of your colon.
- Inflammatory bowel disease: Individuals suffering from ulcerative colitis or Crohn’s disease can also experience anal fistulas. Crohn’s disease is a chronic condition whereby the digestive tract gets inflamed.
Other possible causes:
- Persons who have had a history of trauma in the anal area are also at risk
- People who have had prior radiation therapy in the anal area
- A fistula may also form due to such other conditions as HIV and tuberculosis, cancer, and trauma. However, the formation of a fistula due to these conditions is very rare.
- Individuals with past history of anal fistula or abscess are also at a higher risk
Signs and symptoms of anal fistula
The most common symptoms of anal fistula include:
- Inflammation around your anal region
- You are also likely to experience skin irritation in the area around your anus
- Continuous and excruciating pain that is exacerbated by having a bowel movement, or sitting down. The pain may also worsen in case you cough or move around
- Presence of blood or pus in the stool
- In case of an abscess, you are also likely to experience fever-like symptoms
- Bowel incontinence. As a result, you may have a hard time controlling your bowel movement
- A foul-smelling discharge from a hole adjacent to your anus
- Feeling sick and tired
How to diagnose an anal fistula ?
In case you present with symptoms similar to those of an anal fistula, you will be referred to a healthcare professional who specializes in rectal and colon diseases. The following actions will be performed :
- Our specialists will want to know your health history. The specialists will also be interested in the symptoms that you have been experiencing.
- A physical examination allows the doctors to ascertain whether there is a fistula that adjoins your anal opening. The doctor might have to press this area to ascertain whether there is an abscess. If an abscess is present, there will be pus oozing. Physical examination is not painful.
- A rectal examination also enables the practitioners to palpate the fistula track, along with the adjacent tissues. Palpation helps to reveal whether there is an infection. Alternatively, palpation reveals the extent of your fistula. Your doctors may also ask you to squeeze sphincter muscles around a finger inserted into your anus. This helps to demonstrate the functionality of your sphincter muscles. Consequently, the practitioner is better able to establish whether further tests are necessary.
The doctor may also order further tests to obtain extra information about your condition. Some of the special examinations that your doctor might order include:
- Anoscopy: This test involves having the doctor insert an anoscope made of stainless steel or plastic inside your anus. With this device, the doctor can examine your anal canal from inside for any abnormalities
- Fistula probe: This is a special instrument in the form of a thin and long probe. The doctor inserts this probe inside a fistula via an outer opening. It may be necessary for the doctor to inject a special dye. This special dye allows the doctor to establish the opening of your fistula
What are the methods of treatment available for anal fistula?
There is no medication to treat an anal fistula. Moreover, fistulas cannot heal on their own. Therefore, surgery is the only option available to a patient with this condition. A rectal and colon surgeon performs this surgery. By conducting surgery, the surgeon is interested in getting rid of the fistula and at the same time, ensuring that your anal sphincter muscles are protected. This is because damage to your anal spinster muscles can cause incontinence.
In the case of a simple fistula where only a small portion or none of your sphincter muscle is included, a fistulotomy is the mode of treatment of choice. The procedure entails cutting open the muscles and skin that surrounds the tunnel. The aim of cutting these is with a view to forming an open grove, as opposed to a tunnel. With an open grove, you are also likely to experience bottom-up healing of your fistula tract.
A fistulotomy has proven to be a very effective mode of treatment in the management of anal fistula. However, a fistulotomy may be of limited effectiveness in case the fistula passes via much of your sphincter muscles.
If you are suffering from a complete fistula, it may be necessary for your surgeon to insert a seton. This is a special type of surgical thread that the surgeon inserts in the fistula to facilitate its draining. The seton remains in place for a number of weeks. Once draining has been accomplished, it facilitates healing. In this way, the surgeon does not have to cut your sphincter muscles. A cure for fistula is only accomplished with tighter setons. Tighter setons might necessitate a number of procedures. Our surgeons are happy to discuss these procedures with you.
Advanced flap procedure
Your surgeon may recommend an advanced flap procedure in case they determine that conducting a fistulotomy puts you in great danger of incontinence. Alternatively, an advanced flap procedure is suitable in case your anal sphincter muscles have been affected by the fistula.
The procedure entails scraping out or cutting the fistula. The surgeon uses a flap of tissue to cover the hole The flap of tissue is gotten from your rectum. An advanced flap procedure is characterized by a lower success rate in comparison with a fistulotomy. However, the surgeon does not have to cut through your anal sphincter muscles.
Laser closure of the anal fistula is a new technique that is increasingly being adopted by surgeons for the treatment of anal fistula. The goal of the fistula-tract laser closure is to facilitate the gentle eradication of the fistula tracts while ensuring the sphincter muscle remains intact. This is a very short procedure and you do not have to get admitted for it. It can even be performed in the surgeon’s office. The procedure takes between 30 and 40 minutes under general anesthesia. To perform the procedure, the surgeon inserts a laser fiber from the outside. The laser fiber emits laser energy of a defined amount into the fistula tract. The fistula tract gets destroyed by this laser energy in a controlled manner. Consequently, the fistula tract undergoes extensive collapse due to photothermal destruction. This also hastens and aids in faster healing
Benefits of fistula-tract laser closure
- The healing rate is faster in comparison with the other surgical procedures
- It preserves the anal sphincter thus minimizing the risk of incontinence post-operation
- The procedure is safe for elderly patients and those suffering from chronic diseases, such as hypertension.
- The procedure might trigger local burning
- The patient might experience subcutaneous abscess after an operation. This can be managed with proper dressing and antibiotics
Post-op care and diet
Diet is crucial in the recovery process after anal fistula surgery. A proper diet should include food that gives you fluids and electrolytes. Fiber-rich foods also aid in recovery. However, each individual differs in terms of their dietary requirements. For this reason, our dieticians endeavor to develop a personalized dietary plan for every patient.
We also aim to enable you with post-op care following successful surgery to treat anal fistula. We advise our patients to rest for a few days after surgery. However, we also caution them to desist from walking or sitting for prolonged periods of time. We do regular follow-ups with our patients through phone calls to check how they are doing. We also advise patients on the need to maintain a good position on the toilet seat as this eases the passage of stool.
Additionally, we caution our patients to look out for the following signs and seek urgent medical attention as soon as they become evident:
- Vomiting or nausea
- Excruciating pain, discharge and inflammation
- Inability to control bowel movement
- Failure to experience a bowel movement for the duration of 3 or more days
We are available for assistance 24/7 to attend to your concerns and take appropriate medical attention.
An anal fistula can be quite painful and uncomfortable, especially when it leads to a discharge of pus or blood. This can get in the way of accomplishing your daily tasks. You are better off seeking treatment for anal fistula as soon as possible to avoid the risk of infecting the surrounding tissue. Some of the home remedies for managing anal fistula include eating a fiber-rich diet and using a bulk laxative. However, such remedies rarely provide a permanent solution.
goficure offers an elaborate diagnosis and treatment plan for anal fistula. We are the leading specialists in treating anal fistula in Bangalore. Our team of surgeons have performed hundreds of anal fistula surgical procedures in Bangalore. In the process, they have amassed decades of experience in treating the condition using advanced laser surgery. We recommend laser fistula surgery for treating your anal fistula because :
- The procedure takes a shorter time than conventional surgery
- It is also less painful and invasive, and this promotes faster recovery while also reducing the risk of infection
If you are a resident of Bangalore or even new to this city, goficure is your healthcare provider of choice for treating anal fistula. Our services will benefit you in the following ways:
- We offer consultation services at a discount
- We will assist you in getting your insurance claims and organize transport to the healthcare facility before the surgery
- After surgery, we also make arrangements for your transport back home and assist with post-op consultation
- We offer the most affordable anal fistula laser surgery in Bangalore
- We also work in collaboration with leading nutritionists and health promotion specialists across Bangalore so that we can fast-track your recovery and reduce the risk for anal fistula recurrence through dietary and lifestyle modifications
Exclusive features you get with goficure
1. Dedicated Medi-Pal
A dedicated Medi-Pal is assigned to you. Your Medi-Pal will be your one point contact throughout the treatment and post-op period. They will always be available for you
2. Quick doctor’s appointments
After understanding your concerns, your Medi-Pal will schedule your consultation with a specialist doctor. Your doctor will carry out necessary tests and advise the course of treatment
3. Hassle-free treatment
If you opt to get the surgery done, goficure will take care of it completely. Right from booking your surgery, claiming your insurance to being with you throughout the procedure, your Medi-Pal will do it all
4. Post-op recovery support
Your Medi-Pal would ensure quick recovery. This includes booking your follow up consultations and helping you with doctor-recommended steps for diet & exercise
Smooth and hassle-free
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Post procedure care and follow-ups
Our engagement doesn't end after your surgery. It continue until you go back to your normal life. Free diet and exercise consultations during your recovery phase are offered to ensure a quick recovery