What is Anal fistula?
An anal fistula is the result of an infection of an anal gland.This infection arises inside the anal canal and forms a track or a tunnel which opens on to the skin around the anus.The problem usually presents with a small boil near the anal opening.This ruptures and discharges thin fluid or pus.The discharge dries up in a few days only to come back again after a few weeks.Unless treated effectively this problem persists for even months or years
What causes Anal fistula?
The anal canal normally has glands which secrete mucus.When one of these glands gets infected it forms an abscess.At times this infection can burrow out of the anal canal and tunnel to the skin around the anus opening out as a fistula.
Sometimes a few diseases of the large intestine can present with a fistula.These diseases include Crohn's disease, sexually transmitted infections, trauma, tuberculosis, diverticulitis etc.
How is anal fistula diagnosed?
The best person to manage an anal fistula is a surgical gastroenterologist or a colorectal specialist surgeon.The diagnosis is usually easily made by a physical examination and a rectal examination.For further clarity on the exact length and direction of the fistula, there are advanced methods employed nowadays.These include an MRI fistulogram and an endoanal ultrasound which can clearly map the fistula tract.This is very important for an accurate treatment planning.
How is anal fistula treated?
An anal fistula is a long standing established infection of the anal region.Medicines cannot completely cure it.The fistula has to be treated up to its root which is buried deep in the anal canal.The external pus discharging site is like a chimney.The actual stove is buried deep inside.Surgery is the best method for a permanent cure.
Can you tell me about the surgery for the fistula?
There are various surgical methods employed for treating fistulae.The choice of the procedure depends on the complexity of the fistula.If the fistula is high it can involve the muscle which keeps control over the passing of stools(external anal sphincter).These fistulae need staging surgery to safeguard the sphincter.This is done in two or three sittings spaced out over a few weeks.Majority of the fistulae are simple and a single procedure is sufficient for their cure.
How long does it take to recover after a fistula surgery?
Surgery for fistula is commonly done as a day care procedure.The patient is sent home usually on the same evening or sometimes the next morning.Most of the times the wound is left open to allow it to heal by itself.But it is not necessary to have daily dressings or bandages over it.The patient is fit to resume his normal life and work by three days following the operation.The pain after fistula surgery is usually moderate and recovery is fast.
Authored By Dr G Parthasarathy - Surgical Gastroenterologist, Hyderabad