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Dr QM Leong

What You Should Know About Anal Fistulas: 6 Must-Read Facts

what you should know about anal fistulas

Anal fistulas are due to trauma, infection, inflammation or cancer. They are found around the rectum and sigmoid colon. Symptoms include pain during bowel movement, discharge from the affected area, bleeding, and abscess formation.  

Doctors use several tests to diagnose anal fistulas, including endoscopy, ultrasound, MRI, CT, and biopsy. Treatment options depend upon the type of fistula. Surgery is often required to repair the damage done to the surrounding tissues. Here are the things to know about anal fistula:

An anal fistula is a medical condition wherein a small tunnel communicates between the skin and the rectum. Anal Fistula could occur due to trauma, inflammation, congenital defects, cancer, infections, inflammatory bowel disease, radiation therapy, surgery, childbirth, etc.

Symptoms of an anal fistula include:

  • Skin irritation around the anus
  • A constant, throbbing pain – especially during defecation
  • Smelly discharge from near your anus
  • Passing pus or blood in the stool
  • Difficulty controlling bowel movements

An anal fistula is a chronic disease with damage to the anal opening causing faecal matter to leak out of the body. It happens because of inflammation or infection in the anal area. Depending on how far the hole extends into the rectum, there are different types of fistulas. 

Some fistulas don’t cause symptoms, while others do. If you notice blood coming from the toilet, it could mean you’re leaking stool. You might experience pain during bowel movements or be unable to control your bowels. Other symptoms include fever, nausea, vomiting, weight loss, fatigue, and abdominal cramps.

2. What Causes Anal Fistulas?

Fistula are most commonly caused by an infection at the perianal region. As the infection progresses, the pus tends to erupt at the skin and at the rectum, causing an abnormal communication between the rectum and the perianal skin. 

The most common type of fistula is called cryptoglandular. It happens when faecal matter leaks out of the intestines. It forms under the skin and connects to another part of the body. Cryptoglandular fistulas usually affect women.

3. How Are Anal Fistulas Diagnosed?

People who experience anal fistulas might notice blood in the toilet paper or the stool. They might feel pain during bowel movements. Some people might even see pus coming out of the anus. These symptoms are common among people who suffer from anal fistulas. 

If you experience any of these signs, it is important to seek medical attention immediately. Doctors often ask questions about your personal health history before diagnosing an anal fistula. 

Doctors also look into the severity of your symptoms. For example, if you have frequent diarrhoea, you probably have a mild anal fistula. On the other hand, if you have severe pain while passing stool, you probably have severe complications.

  • A colonoscopy is required for diagnosis. During a colonoscopy, doctors examine the entire digestive system. In addition, they check for polyps, tumours, ulcers, and inflammation. Colonoscopies are performed once every ten years. However, some people require multiple colonoscopies throughout their lifetime.
  • Fistula probe. A lengthy and slender probe is inserted into the fistula through the fistula’s external orifice. To locate the opening of a fistula, a specialised dye may be injected into the patient.
  • Anoscope. Anoscope is a specialized scope inserted into your anal canal to view and detect the fistula.
  • MRI. The best imaging modality for the preoperative evaluation of individuals with anal fistulas is magnetic resonance imaging (MRI). MRI aids in correctly displaying illness progression and determining prognosis. This, in turn, facilitates decision-making about and monitoring of therapy.

4. Management and Treatment

management and treatment room

Fistulas often occur in patients with inflammatory bowel diseases such as Crohn’s disease and Ulcerative Colitis. They usually form because of ulcers caused by inflammation. The treatment of choice depends on where the fistula is located and how much it drains. In most cases, surgery is necessary.

5. Diagnosis and Tests

An anal fistula is usually found during routine pelvic exams. A fistula is a hole that connects one part of the body to another.

6. Would A Follow-Up Treatment Be Necessary For An Anal Fistula?

Anal fistula are abnormal passages that form inside the anus and they can happen to anyone. Anal fistula usually does not heal without surgery

However, there are certain situations where surgical correction is required. Patients with recurrent fistula, those with complex fistula, and those with persistent symptoms despite appropriate medical management are candidates for surgical intervention. 

The goal of surgery is to close the fistula. The surgery can be done by creating a permanent opening in the intestine, cutting out the diseased tissue, and sewing up the hole. 

A surgeon will typically perform both procedures during one operation. If the patient requires additional surgeries, he or she will likely undergo multiple operations over time.

Conclusion About Anal Fistulas

Anal abscesses are painful infections inside the rectum. They usually occur due to bacterial infection and inflammation. If you develop one, it could become infected, causing pain and swelling around the anal area. 

You might notice blood coming out of the anus and/or pus. These conditions can cause severe discomfort and require medical attention.

Contact Dr. QM Leong to know more about anal fistulas. Get a medical recommendation plan of action if needed, if symptoms occur such as: hemorrhoids, peptic ulcers, gastritis, and other gastrointestinal diseases.

Frequently Asked Questions About Anal Fistulas

Is Fistula An Indication Of Cancer?

A condition called an anal fistula doesn’t often indicate cancer. However, a fistula can develop into cancer if it is not treated.

Most anal fistulas can heal and close, only to reappear at a later time. Fistulas, in most cases, do not heal on their own without surgical treatment.

If you think you could have an anal fistula, you shouldn’t wait to see a medical professional. Your fistula will not be treated by the care you receive at home.

Since no medicines can help, surgery is the gold-standard treatment for Anal Fistula. 

For a simple fistula that isn’t too close to the anal area, the doctor will cut open the skin and muscle around the tunnel. Thus, making it possible for the wound to heal from the inside out. 

For a fistula that is more complicated, the doctor might put a seton, a tube, into the opening. Before surgery, this helps drain the infected fluid. It could take at least six weeks.

Depending on the fistula, your doctor may have to cut into the muscles that open and close your anus. Note that it may be harder to control your bowels after the procedure.