A small tunnel connecting an abscess to an opening on the skin near the anus is known as an anal fistula. The abscess is an infected cavity in the anus. The faeces pass out of our body through the anus. There are many small glands inside the anus and these glands make mucus. The glands sometimes get clogged and become infected. This leads to the formation of an abscess. A fistula may develop from many abscesses. You need proper diagnostic tests and treatment as a cure for fistula. Many people, who are suffering from this condition,should go to a diagnostic centre in Uttarpara for these tests.
Clogged anal glands and abscesses are major causes of an anal fistula. Some other causes are:
- Radiation therapy for cancer treatment
Anal fistula causes the following symptoms:
- Pain and swelling around the anus
- Frequent anal abscesses
- Pus from an opening near the anus
- Pain during bowel movements
It is advisable to consult a doctor if you have these symptoms.
The doctor will properly examine the area near the anus to detect any opening (fistula tract) on the skin. Then he/she will try to measure the depth of the fistula tract and the direction in which it is going. You may need to undergo some tests at a pathology lab in Hooghly if the fistula is not visible on the skin. These include:
Anoscopy: A special instrument is used in this procedure to view the inner area of your anus and rectum.
Ultrasound or MRI of the anal area: This helps the doctor to properly view the fistula tract.
The doctor may suggest some additional tests if he/she finds a fistula. This is to confirm whether the fistula has any connection with Crohn’s Disease. These tests include X-rays, blood tests and colonoscopy.
After the doctor confirms the presence of anal fistula from the results of the tests done at a pathology lab in Uttarpara, treatment begins. As anal fistula does not get healed by itself, you need to undergo a surgery to get rid of it. The use of general anaesthesia is common during the surgery of an anal fistula. There are few different surgical procedures.
A fistulotomy is the most common type of surgery effective for treating anal fistula. The surgeon opens up the fistula by cutting along its whole length. He/she remains very cautious if it is necessary to cut a small portion of anal sphincter muscle during the procedure.
The surgeon often recommends inserting a seton, if the fistula passes through a significant portion of the anal sphincter muscle. The fistula remains open after this procedure as the surgeon places a piece of surgical thread (seton) in it. The fistula gets healed as this procedure allows it to drain.
Advancement flap procedure
The surgeon cuts or scraps out the fistula and covers the hole, where it enters the bowel, with a flap of tissue from the rectum. There is no need to cut the anal sphincter muscle.
In some cases, the fistulas pass through the anal sphincter muscles and this makes the fistulotomy surgical procedure risky. This is when ligation of the intersphincteric fistula tract (LIFT) proves effective. In the skin above the fistula, the surgeon makes a cut and the sphincter muscles are moved apart. He/she then seals both ends of the fistula and cuts it open so that it lies flat.
Endoscopic ablation and laser surgery are two other procedures to seal the fistula.
The only non-surgical treatment option for treating anal fistulas is treatment done with fibrin glue.