An anal fistula is a small canal that appears at the end of the intestine after the anus, and the end of the fistula can look like a hole in the skin around the anus. The anal fistula is either simple or complex – depending on whether there is a single fistula or a connected network of ducts – On its location and its proximity to the sphincter muscles (rings of muscles that open and close the anus) anal fistula
Anal fistula in terms of causes, symptoms, complications and treatment methods.
Common symptoms of anal fistula
Skin irritation around the anus, palpitations, and persistent pain may be worse when sitting, moving, discharging pus or blood from the canal when there is an intestinal movement.
You should see your doctor if you have any of these symptoms, and you may be referred to a urologist.
Anal fistula usually develops after an abscess in the anus (a group of pus) has not been cured.
The cause of fistula can also be conditions that affect the bowel, such as inflammatory bowel disease (IBD) or bowel obstruction
Anal fistula affects:
Up to 50% of people with Crohn’s disease, 30% of people infected with HIV (the virus that attacks the body’s immune system), and approximately 30-50% of people with anal abscess (this More common in women than men)
Most anal fissures require surgery because they rarely heal if they are not treated. Many surgical methods are available, depending on where the fistula is located and classified if it is simple or complicated.
There may be a possibility of fistula returning after surgery, so you may need to stay in the hospital for a few days if the fistula is difficult to cure.
There is a risk of complications after anal fistula surgery, including intestinal inflammation, urinary incontinence, and recurrent anal fistula.
For example, the risk of returning anal fistula is about 21%, and the risks vary depending on the type of fistula, and you can discuss this with the surgeon who is doing the surgery for you.
More Symptoms of Anal Fistula:
Skin irritation around the anus, palpitations, and persistent pain may be worse when you sit, move, discharge pus or blood from the canal when there is an intestinal movement.
If the fistula is caused by abscess which you still have, you may have: high temperature and a general feeling of fatigue and fatigue.
If the cause of fistula is inflammation of the intestine (part of the digestive system) – for example, because of a condition such as Crohn’s disease – you may also have abdominal pain, diarrhea, loss of appetite, weight loss, nausea, and vomiting.
Types of anal fistula:
Usually, the anal fistula is classified as follows: Simple or complex – Depending on whether there is a single fistula or a connected network depending on its proximity to the sphincter muscles, the sphincter muscles are two rings of muscles that open and close the anus.
The most common types of anal fistula are:
Intersphincteric fistula – The fistula channel crosses the inner sphincter and opens on the skin surface next to the anus.Other types of anal fistula can begin in another part of the colon (the large intestine) and extend in a different direction so as not to open fistula next to the anus and develops in the form of a horseshoe, with two open limbs next to the anus.
Causes of Anal Fistula:
The most common causes are an anal abscess, and can also be caused by some problems affecting the intestine (part of the digestive system).
1. Anal abscess: Abscess is a collection of pus, and the development of the abscess usually after a small gland inside the anus become infected with bacteria.
The cause of an abscess is often unknown, although cysts are more common in people with immunodeficiency, such as HIV or AIDS.
Hemorrhoids are usually treated with antibiotics (to treat infections caused by bacteria), and in most cases, you will also need to discharge the abscess from the pus and pus. Approximately 30-50% of the abscesses in the anus develop into anal fistula, and about 80% of the anal fistula causes anal inflammation.
2. Inflammation of the bowel:
Anal fistula can be a complication of problems that cause inflamed intestines such as Crohn’s disease, a chronic condition that causes inflammation of the intestinal lining, and Crohn’s disease is a type of bowel inflammation (IBD).
3. Other causes:
Inflammation or other problems that can cause anal fistula include: rectal cancer which is the area that is located at the end of the colon where the TB stools are stored – bacterial infections that mainly infect the lungs, but can also spread in different parts of the body.
HIV and AIDS – a virus that attacks the body’s immune system – chlamydia – sexually transmitted infection – syphilis – sexually transmitted infections. Drug injection or transfusion.
Research shows that smoking increases the risk of anal abscess or fistula, and smoking cessation reduces these risks.
Treatment of Anal Fistula:
Surgery is usually the treatment of anal fistula and very few can be cured on its own. The type of surgery depends on the case of fistula and whether it is classified as simple or complicated, the surgeon may be able to explain it to you in more detail.
The aim of the surgery is to get rid of the fistula while avoiding damage to the sphincter muscles because damage to the sphincter muscles can lead to bowel incontinence, where your bowels cannot be controlled.
Anal fistula surgery is usually done under general anesthesia when you are unconscious and you can not feel anything. In some cases, a local anesthetic is used, where you are conscious but the area you are treating is under anesthetic so you do not feel any pain.
Fibrin Glue: Fibrin glue is currently the only non-surgical option for the treatment of anal fistula, where the fibrin glue is injected into the fistula to close the openings. Fibrin may appear to be an attractive option because it is a simple, safe and painless procedure. However, the results appear long term and show success at 77%, but after 16 months.