Anal Fistula: What Is It? How Is It Diagnosed and Treated?

An anal fistula is a troublesome health problem affecting the anal and rectal area, significantly impacting a patient's quality of life. It's a common condition that requires accurate diagnosis and appropriate treatment to avoid potential complications.

What is an Anal Fistula?

An anal fistula is a small canal or tunnel that forms between the end of the intestine (rectum) and the skin surface near the anus. It develops as a result of an abscess (a collection of pus) in the anal area that wasn't treated correctly, leading to the formation of this abnormal channel connecting the inside of the anus to the outside.

Causes of Anal Fistula

A fistula usually forms due to an infection of the small glands inside the anal canal, which secrete substances to facilitate defecation. If these glands become blocked, an abscess can form, leading to the later appearance of a fistula. Other causes include:

• Chronic infections in the anal area.

• Crohn's disease (a chronic inflammatory bowel disease).

• Infections resulting from bacterial or viral contamination.

• Previous injuries or surgeries.

• Tuberculosis or certain sexually transmitted diseases (rare).

Types of Anal Fistula

Anal fistulas are classified based on their location and relationship to the anal muscles:

1. Simple Fistula: A single, narrow channel close to the anal opening.

2. Complex Fistula: Contains more than one channel and has branches, possibly passing through multiple muscles.

3. High Fistula: Located deep and passes through multiple anal sphincter muscles.

Symptoms of Anal Fistula

Common symptoms of an anal fistula include:

• Recurrent or persistent pain in the anal area, especially when sitting or during bowel movements.

• Purulent or bloody discharge from an opening near the anus.

• Itching or irritation of the surrounding skin.

• Swelling or a palpable mass.

• Foul odor resulting from the discharge.

• Sometimes a fistula is accompanied by fever if an abscess is present.

How Is Anal Fistula Diagnosed?

Fistula diagnosis relies on a thorough clinical examination by a specialized doctor, and may include:

• Clinical examination: To observe the external opening or any discharge.

• Digital rectal examination: To feel for internal channels.

• Anal ultrasound or MRI: To accurately determine the fistula's path and diagnose its type.

• Fistulography (dye injection) or endoscopy: In some cases, to identify internal extensions.

Anal Fistula Treatment

The primary treatment for an anal fistula is usually surgical, depending on the type and location of the fistula:

1. Traditional Surgical Treatment

• Fistulotomy: The channel is opened and cleaned to heal from the inside out.

• Seton placement: Used in complex cases to maintain the channel's path and prevent damage to the anal muscles.

• Grafting with biological plugs: Used in some cases to reduce complications.

2. Laser Treatment

One of the latest fistula treatment methods, performed using precise devices such as the German "Leonardo" device.

• The internal channel of the fistula is closed without the need for surgical opening, which reduces pain and speeds up recovery.

• It is a quick and safe procedure that reduces the chances of recurrence.

Recovery Period After Treatment

• With traditional surgery: The recovery period takes one to three weeks, depending on the type of operation and the patient's condition.

• With laser treatment: The patient may return to normal life within only a few days.

It is advisable to maintain cleanliness of the area and eat fiber-rich foods to avoid constipation.

Can an Anal Fistula Return After Treatment?

In some cases, a fistula may return, especially if it was not treated correctly from the start or if it was a complex type. Therefore, it is essential to choose a specialized medical center that relies on precise diagnostic and treatment techniques, with an experienced medical team.

Hemocure's Advice

Do not ignore any pain or abnormal discharge from the anal area. The earlier an anal fistula is diagnosed, the faster and better the chances of recovery. At Hemocure Foundation, we offer the latest laser treatment methods without traditional surgical intervention, to ensure patient comfort and safety.

Conclusion

An anal fistula is a medical condition that requires accurate diagnosis and prompt management, as it can cause troublesome complications if not treated appropriately. The journey to dealing with it begins with understanding the symptoms and accurately diagnosing them through clinical examination and possibly some imaging techniques. Treatment depends on the type and extent of the fistula, ranging from traditional surgical intervention to the use of modern techniques like laser.

Maintaining personal hygiene, treating any infections or abscesses early, and continuous medical follow-up are key to preventing anal fistulas and reducing their recurrence. Finally, it is always advisable not to ignore any unusual symptoms in the anal area and to consult a specialized doctor as soon as possible for an accurate diagnosis and appropriate treatment.