When to seek Medical Attention for Anal Fistula?
Fistulas require immediate medical attention from best fistula doctor in Chennai to prevent serious infections or other complications. An inflammation that causes sores, or ulcers, to form on the inside wall of the intestine, rectum, anus or nearby organs, lead to the development of fistulas. A tunnel called the fistula is created when such ulcers extend through the entire thickness of the bowel wall to drain the pus out from the infected area through the anus.
What is anal fistula?
The anus is the external opening through which faeces are expelled from the body. An infection near the anus causing a collection of pus forms an abscess in the nearby tissue. There are a number of glands inside the anus that make mucus. An abscess that is formed when these glands get occasionally clogged and become infected may also develop into a fistula. A small channel may be left behind, even after the pus drains away. Other not so common causes of anal fistulas include:
- Crohn’s disease is a chronic condition where the digestive system becomes inflamed.
- Diverticulitis is an infection and inflammation of the small pouches that form on the sides of the large intestine.
- Hidradenitis Suppurativa is a long term skin condition that causes abscesses and scarring.
- Infection caused from tuberculosis, HIV or STDs
- Radiation (treatment for cancer)
- A complication of surgery near the anus
Symptoms of anal fistula
Anal Fistula causes unpleasant symptoms of discomfort and skin irritation, that do not usually get cured without Fistula treatment in Chennai. On persistent symptoms of an anal fistula, an examination for any bowel conditions would be necessary. It is advisable to get medical advice on observing signs and symptoms of anal fistula that include:
- skin irritation in the anal region
- frequent anal abscesses
- throbbing pain that is usually constant and gets worse on sitting, moving, passing motion or coughing
- The end of the fistula may not be visible but can be felt as a hole in the skin near the anus
- smelly or bloody discharge from the opening near the anus
- passing stools with pus or blood
- abscess with swelling and redness around the anal opening accompanied by high body temperature, chills or fatigue
- some cases may have difficulty in controlling bowel movements
Medical diagnosis of anal fistula
An anal fistula is usually diagnosed by examining the area around the anus, that includes looking for an opening of the fistula tunnel on the skin. The depth and direction of the tract are also examined. The examination in many cases reveals a discharge from the external opening. If the opening of fistula on the skin's surface is not visible, it may be necessary to perform additional tests such as:
- A procedure using an anoscope, a special instrument to see inside the anus and rectum.
- A better view of the fistula tract may be required through an ultrasound or MRI.
- In some cases, an examination in the operating room, under anaesthesia may be needed to diagnose the fistula.
- Further tests like blood tests and X-rays may be called for to see if the condition is related to inflammatory diseases of the intestine, like the Crohn’s disease.
- A procedure called colonoscopy that uses a flexible, lighted instrument inserted into the colon via the anus may be performed on the patient under light anaesthesia for conscious sedation.
- A long, thin instrument called the fistula probe guided through the outer opening of the fistula may be used to inject a special dye and know the opening of the fistula on the inside.
Medical advice includes surgery for anal fistula
An infection that starts in an anal gland is the cause for most anal fistulas. The abscess caused due to the infection, may drain on its own leaving the drainage tunnel that connects the infected gland to the hole on the skin surrounding the anus, open. If the drainage doesn’t happen on its own, a surgery to drain it through the skin next to the anus may be necessary.
An anal fistula is almost always cured these days by latest laser treatment of Anal fistula. Nonsurgical treatments may be an option only in rare cases. The challenge of the surgery is to remove the fistula while protecting the anal sphincter muscles.
If the anal sphincters are damaged, it could cause incontinence. When sphincter muscle are not or little involved in the fistula, fistulotomy is the first line of treatment. This procedure allows the skin and muscle over the tunnel to be cut open so that the tunnel is converted in to an open groove.
This way, the fistula tract heals from the bottom up. More complex fistulas require a special drain thread called a seton, to be fixed and needs to remain in place for a minimum of 6 weeks’ time. A follow up procedure is almost always performed and that can be either
- An advanced flap procedure to cover the fistula with a flap, or piece of tissue, taken from the rectum
- A lift procedure where the skin above the fistula is released, the sphincter muscles are extended and the fistula is closed.
Crohn’s disease fistulas may be treated differently by injecting stem cells into the fistula.
Fistula specialist in Chennai with expertise in minimally invasive surgery techniques will be able to provide surgery options that are usually done on an outpatient basis, require smaller incisions and shorter recovery times.
This means the patient can go home the same day unless the patients has very large deep fistula tunnels requiring to stay in the hospital for a short time after the surgery. On getting prompt medical advice for anal fistula, the abscess and fistula can be treated properly that allows better healing, avoid complications and prevent recurrence of fistulas.