An Anal fistula also called as fistula- in-ano, is a tunnel that runs from inside the anus and the outside skin around the anus.The anus is the muscular opening at the end of the digestive tract where stool exits the body.
It usually follows an infection that didn’t heal the right way. Doctor can treat infection symptomatically , but Surgery is usually needed to treat an anal fistula. Sometimes without surgical treatments may be an option.
Causes -
Just inside anus there are several glands that make fluid. Sometimes, they get blocked or clogged. Most anal fistulas are caused by an infection that starts in an anal gland. The infection results in an abscess that drains on its own or is drained surgically through the skin next to the anus.
If patient don’t treat the abscess, it’ll grow. Eventually, it’ll make its way to the outside and punch a hole in the skin somewhere near patients anus so the gunk inside it can drain. The fistula is the tunnel that connects the gland to that opening.
Most of the time, an abscess causes a fistula. Rings of sphincter muscle at the opening of the anus allow to control the release of stool. Fistulas are classified by their involvement of these sphincter muscles. This classification helps the surgeon to determine treatment options.
It’s rare, but they can also come from conditions like tuberculosis, sexually transmitted diseases(S.T.D.), or an ongoing illness that affects patients bowels, such as Crohn’s disease or ulcerative colitis.
Symptoms of Anal fistula-
Symptoms of an anal fistula can include-
• Pain(Pain in the rectum and anus, especially when sitting or passing stool)
• Redness
• Swelling around anus
• A red, inflammed area around the tunnel opening
• An opening on the skin around the anus
• Oozing of pus, blood or stool from the tunnel opening
• Bleeding
• Painful bowel movements or urination
• Fever
Diagnosis-
Medical history
Physical examination-
Some fistulas are easy to spot. Others aren’t. Sometimes they close on their own, then open back up.doctor will look for signs of oozing fluid or bleeding. Doctor might stick a finger into patients anus during the exam.
Imaging tests- X-rays or a CT scan.
Colonoscopy
Treatment-
There’s no medication to fix the condition, so surgery is used.
For a simple fistula that isn’t too close to patient anus, the doctor will cut open the skin and muscle surrounding the tunnel. This allows the opening to heal from the inside out.
• They may use a plug to close the fistula.
• For a more complicated fistula, the doctor might put a tube known as a seton into the opening. This helps drain the infected fluid before surgery. It could take 6 weeks or more.
Depending on where the fistula is, doctor may have to cut into the sphincter muscles that open and close patients anus. They'll try not to damage them, but it may be harder to control patient bowels after the procedure.
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