Causes, Symptoms and Treatments for Fistulas

A fistula may be defined as an abnormal tube shaped connection that is usually formed between two organs or vessels which have a lining of epithelial cells. One of the most common types is anal fistula. This fistula is a small tunnel that connects an infected gland or cavity (called an abscess) within the anus to a skin opening in the skin outside it.

The formation of an anal fistula may be further explained as follows. The external opening through which faeces is excreted from the body is called the anus. There are several small glands within the anal region which form the mucus. Sometimes, the clogging of these tiny glands can result in an infection leading to the development of a fistula.

Causes of Anal Fistula

Most fistulas are formed due to clogged anal glands and abscesses.Other common causes which can cause fistulas are-

• Side effects of radiation used for treating cancer
• Crohn’s disease-an inflammatory intestinal disease
• Injury/Trauma
• Infectious ailments like tuberculosis and HIV
• Sexually Transmitted Diseases(STD)
• Cancer
• Diverticulitis-a large intestine disorder in which there is formation of small pouches which subsequently get inflame
• Post-surgery complications near the anus
• Some long-term effects of skin problems like Hidradentis Suppurativa which result in scaring and abscesse
• Frequent bowel disorders

Symptoms of Anal Fistula

• Pain, redness, swelling or skin irritation around the anus
• Bleeding
• Continuous and throbbing pain what increases in sitting position, while doing movements or passing stools
• Uncomfortable or painful bowel movements or urination
• High temperature or fever, chills and general weakness along with presence of abscess
• Foul-smelling, smelly liquid discharge(pus) oozing near the anal hole
• Blood or pus in the stools
• Difficulty in controlling bowel movements(bowel incontinence)
• Frequent occurrences of anal abscess

Diagnosis of Anal Fistula

It is important to consult a doctor if there are persistent symptoms of an anal fistula. A physical examination of the patient may be needed to confirm its presence. Subsequently, the patient is likely to be referred to a colorectal surgeon to confirm the diagnosis and determine the most suitable roadmap for treatment. Some diagnostic tests done in this regard are-

• Rectal examination
• Ultrasound imaging tests, CT Scan or MRI
• Proctoscopy , a clinical procedure in which a special telescope with lighting is used to examine the anal region  

Additionally, patients with Crohn’s Disease may also be asked to undergo x-rays, blood tests and colonoscopy for ensuring appropriate clinical investigation.

Treatment of Anal Fistula

Usually medications cannot resolve the problems of anal fistula. Surgery is needed as the fistula does not heal by itself when left untreated. The aim of the surgery is to create a balance between eliminating the fistula completely and ensuring that the sphincter muscles are not damaged in the process as it can result in incontinence.

The types of surgeries include-

• Fistulotomy that involves cutting open the complete length of the fistula so that it heals itself into a flat scar. This approach is usually used to treat simple fistulas.The surgeon may also use a plug to close the fistula. This surgery may be done in an outpatient setting and the patient is discharged on the same day.

• Seton procedures are used for treating complicated fistulas. In this, a surgical thread called seton is inserted in the fistula and retained there for several weeks to ensure that the infected fluid drains out completely to heal the fistula properly. Later, further procedures may be carried out to treat the fistula.For this, the options include

• Fistulotomy

• Advanced flap procedure wherein the fistula is covered with a flap or a piece of tissue taken from the rectum

• Lift procedure in which the skin above the fistula is opened up,the sphincter muscles are spread without damaging them and fistula is tied off.

Patients having large and deep fistula tunnels normally require this procedure and may need to be hospitalized for a few days.Gastro surgeons in Chennai provide the latest advanced treatment for fistulas includinglaser surgery and usage of stem cells.

Most patients recover well after fistula surgery and do not face recurring problems. Anal fistula treatment in Chennai is known for promising results. For consulting the best fistula doctors in Chennai or getting reliable fistula surgery in Chennai please contact Chennai Gastro Care.