What Is An Anal Fistula?
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What Is A Perianal or anal Fistula?
An anal fistula is an abnormal tunnel connecting the last part of your GI tract to the skin around the anus. The most common location for a fistula in the digestive tract is around the anus.
Small glands inside the anus clog and become infected, forming anal fistulas. These clogged glands lead to perianal abscesses, which may develop into fistulas.
The terms “anal” or “perianal” are used interchangeably to describe fistulas involving anal tissue. Seek professional medical treatment promptly to avoid lasting harm such as nerve damage or kidney failure.
Ignoring proper care can result in further infections and ongoing discomfort for sufferers.
Types Of Anal Fistulas
Specific types of anal fistula exist, and determining your type can guide the most effective medical treatment approach.
Anorectal Fistulas
Infected glands in your anus or rectum create canals that extend to the skin around the anal opening.
Rectovaginal Or Anovaginal Fistulas
Like anorectal fistulas, these develop when an infection forms a passageway, but here it connects the rectum or anus to the vagina.
Colovaginal Fistulas
Deeper fistulas within the digestive tract can extend from the colon to organs like the bladder, vagina, or small intestine, or even to the skin’s outer surface.
Symptoms of Anal Fistulas
A variety of symptoms can accompany an anal fistula, although many overlap with other conditions. If you experience any of the following, it’s advisable to consult a medical professional:
- Fever, chills and/or fatigue
- Nausea, vomiting and/or diarrhea
- Abdominal pain
- Skin irritation around the anus
- Constant pain in the area, often worse when sitting, moving or going to the bathroom
- Foul smelling discharge near the anus, possibly with pus or blood
- Pus or blood in the stool
- Swelling and redness around the anus
- Bowel incontinence
If you’re experiencing any of these issues, be sure to promptly discuss them with a healthcare provider.
Causes Of Anal Fistulas
Sometimes, identifying the precise cause of a fistula can be challenging; medically, these cases are termed idiopathic. However, many are linked to inflammatory conditions like Crohn’s disease.
A study revealed that 44% of individuals with Crohn’s disease exhibited features consistent with potential fistula development within six months of diagnosis.
Yet, Crohn’s disease isn’t the sole culprit; other potential causes exist as well:
- Diverticulitis
- Tuberculosis
- Chlamydia
- Certain cancers
- Radiation therapy
What generally happens in the formation of an anal fistula is that one of the glands in the anorectal region becomes abscessed – that is, it develops an infection. There are between 8 and 10 glands in the area that can become infected, and as that infection grows, it creates pressure that pushes outward into the muscle wall and creates a canal.
Treatment Options For Anal Fistulas
Discussing these issues may be uncomfortable, yet seeking medical attention if you suspect a fistula is crucial. Successful treatment often necessitates surgical intervention, although not invariably.
Several qualified professionals, including gynecologists, urologists, urogynecologists, and colorectal surgeons, are adept at addressing such concerns routinely. After your examination, you’ll likely be offered one of the following treatment options:
Non-Invasive Treatments
Some patients are fortunate that their condition can actually be treated non-invasively. There are a number of therapies that your physician may try to address your condition, including:
- Fibrin glue – You may have heard about how glue is being used more frequently than ever in medicine – it’s used as a liquid bandage, to seal incisions following surgeries and, in fistula repair, to glue the fistula shut. Not all fistulas are candidates for this treatment, but those that are often have excellent results.
- Plugs – Collagen is used as more than just a cosmetic filler nowadays. When it comes to repairing a fistula, your physician may inject a collagen matrix into the affected area, sealing it off.
- Catheters – You may be familiar with the idea of a urinary catheter – that is, a tube that drains liquid from the bladder. A catheter in a fistula works in much the same way. These are small tubes or similar devices that are used to drain the infection, typically on smaller fistulas that are actively infected.
Pharmaceutical Treatments
- Antibiotics. We all know that antibiotics work great on ear infections, eye infections and bacterial infections of all sorts. That’s why it should come as no surprise that antibiotics may also be used to treat the infection that’s causing your fistula. While there is no medication that can eliminate the fistula itself, stopping an active infection is an important step on your path towards healing.
- Stem Cells. One new treatment that is being tried for Crohn’s sufferers is the use of stem cells injected into the fistula to promote repair – it’s worth asking your physician for more information and to learn if this might be an option for you.
Surgical Treatments
Discussing these issues may be uncomfortable, yet seeking medical attention if you suspect a fistula is crucial. Successful treatment often necessitates surgical intervention, although not invariably.
Several qualified professionals, including gynecologists, urologists, urogynecologists, and colorectal surgeons, are adept at addressing such concerns routinely. After your examination, you’ll likely be offered one of the following treatment options:
- Transabdominally – that is, he or she will make a small incision in the abdominal wall to access it.
- Laparoscopically – through a tiny incision and with the use of cameras as guides.
Discussing these issues may be uncomfortable, yet seeking medical attention if you suspect a fistula is crucial. Successful treatment often necessitates surgical intervention, although not invariably.
Several qualified professionals, including gynecologists, urologists, urogynecologists, and colorectal surgeons, are adept at addressing such concerns routinely. After your examination, you’ll likely be offered one of the following treatment options:
Setons For Fistulas
When a fistula traverses a significant portion of the anal sphincter muscle, surgeons may propose Seton techniques.
These techniques involve inserting a Seton, a surgical thread, into the fistula for several weeks to keep it open for drainage and healing. This method offers the advantage of avoiding the need to cut through the sphincter muscles, which carries risks. However, loose Setons only facilitate drainage and do not provide a complete cure.
In some instances, tighter Setons may gradually cut through the fistula, necessitating multiple procedures.
Alternatively, surgeons may recommend several fistulotomy procedures, where a small section of the fistula is opened carefully each time. The optimal treatment approach will depend on your specific situation, which your surgeon will thoroughly discuss with you.
Talking To Your Doctor About Fistulas
There are few things less pleasant than surgery, but one of them may be an untreated fistula. Getting help is worth the modest degree of discomfort and embarrassment that come with the territory – the high rate of success from active treatment should encourage you to seek care.
And if you shudder at the idea of talking with a doctor about such a personal issue, click here for tips on how to have a productive, comfortable, and confident conversation with your physician.
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