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What is Fistula?

A fistula is an abnormal opening that can develop between the anal canal's end and the skin that surrounds it. It is a common condition for people who have had or are suffering from an anal abscess, a cavity filled with pus. The majority of fistulas are caused by fissures, so the early detection and treatment of a fissure will prevent it from turning into a fistula. However, Laser treatment for fistula is the permanent solution.

What are the Risk Factors of Anal Fistula?

It is quite common among men aged 20 to 40. It can be caused by a variety of factors. The major reasons that cause anal fistula are blocked anal glands & anal abscesses. Other conditions that can cause an anal fistula include:

1. Infection in the anal glands
2. Constipation
3. Abscess in the large intestine
4. Crohn's disease or other inflammatory bowel disease
5. Radiation treatment 
6. Trauma
7. Tuberculosis
8. Diverticulitis 
9. Cancer
10. Long-standing abscess
11. Underlying Medical conditions 
12. Sexually Transmitted Diseases
13. Injury during childbirth
14. Complication following surgery in the pelvic area

What are the types of fistula?

Following are the most common types of fistulas:

1. Anal fistula
2. Anorectal
3. Rectovaginal or Anovaginal
4. Colovaginal
5. Intestines
6. Urinary tract

Symptoms of Anal Fistula:

The following are symptoms of anal fistula that must be treated immediately:

1. Throbbing pain that worsens on sitting
2. Swelling, itching or redness around the anal area
3. Pus, blood, and debris are discharged, which has an unpleasant odor.
4. Fever due to infection and pus.
5. Constipation and painful bowel movement.
6. Bleeding
7. Pain during bowel movements/urination
8. Irritation in the external female genital organs
9. Frequent urinary tract infections/urination
10. Constant urine leakage from the vagina
11. Fluid drainage from the vagina
12. Nausea ,Vomiting & Diarrhea
13. Abdominal pain
14. Gas, faeces, or pus passing through your vaginal canal
15. Pain during sexual intercourse
16. Weight loss

Diagnosis of Anal Fistula:

The doctor will ask about your medical history and perform a physical exam to determine if you have an anal fistula. Anal Fistulas are usually easy to detect, symptoms such as bleeding or seeping fluid from the anal region will be examined by the doctor. Your doctor may prescribe an Endoscopic Ultrasound or an MRI to characterise the fistula tract if it is not evident on the skin surface. To detect the anal fistula, your doctor may also recommend imaging tests such as CT scans or X-rays, as well as colonoscopy, sigmoidoscopy, or a fistulogram. Barium contrast X-rays, MRIs, and CT scans can be used to diagnose or examine internal fistulas. If a digestive ailment, such as Crohn's disease, is suspected as the source of the anal fistula, the patient may be advised to take blood tests, X-rays, and a colonoscopic examination.

Fistula Treatment Procedure:

Antibiotics and other drugs may help some anal fistulas heal, but the majority requires surgery. The treatment techniques of anal fistula are classified into two categories:

1. Laser treatment for fistula
2. Traditional Surgical Method 

Following are some techniques of treatment depending on the condition of the patient:

1. Fistulotomy
2. Seton placement Surgery
3. Endoscopic ablation
4. LIFT procedure
5. Advancement rectal flap
6. Anal fistula plug / Collagen plug (or) Fibrin glue 
7. Ostomy and stoma
8. Muscle flap

Laser treatment for fistula:

• FiLaC (Fistula-tract Laser Closure)
• Distal Laser Proximal Ligation (DLPL)

What are the benefits of laser treatment for fistula over open surgery:  The following are some of the excellent or incredible advantages of laser Fistula treatment:

1. Quick recovery
2. Day care procedure
3. No risk involved
4. No bleeding 
5. No cuts or stitches
6. No pain
7. No chance of infection
8. No Recurrence

Precautions To Be Taken After Fistula Surgery:

Healing or Recovery time is variable from individual to individual but on average your surgical wound may take 1-4 weeks to heal. 

Precautions to be followed after surgery:

1. Keep your Fistula clean and Dry
2. Sitz bath
3. Take medication prescribed
4. Follow post-surgery diet instructions
5. Check and maintain proper blood flow through the fistula
6. Avoid rough handling of your wound & handle smooth
7. Regular dressing
8. Avoid strenuous work
9. Contact your doctor immediately if you experience
10. Bleeding from the surgical wound site
11. Oozing of pus from dressing site
12. Fever above 101 degrees of Fahrenheit
13. Persistent nausea and vomiting
14. Bloating