Diagnosing & Treating Anal Fistula
Anal fistulas are basically small channels which develop within the anal canal & the skin near anus. End of fistulas usually appear as hole in skin around anus. Anus or anal aperture is the opening through which fecal wastes leave the body. Anal fistulas are normally classed as either simple or complex & low or high fistulas. While simple fistulas involve a single fistula tract, complex fistulas have interlinking connections. Low or high fistulas are classified depending upon the position & closeness of the fistula to the anal sphincter muscles.
Is it Time to See My Doctor?
Perhaps! Some of the most common signs & symptoms of anal fistula include the following.
- Irritation of skin around anus
- Throbbing & constant pain which is getting worse with moving around, sitting down, during bowel movement or with cough
- Rectal Bleeding – Discharge of blood or pus during bowel movement
Yes, it is time to see a doctor if you experience any of these symptoms. The general physician may then refer you to a specialist who is known as a colorectal surgeon for further investigation.
Diagnosing Anal Fistula
The doctor will look at your medical history & carry out a physical examination for diagnosing anal fistula. Further tests may be required if there are multiple fistulas for determining their position. The doctor will also pay due attention to check if you are having inflammatory bowel conditions like Crohn’s disease. Subsequently you would be referred to a colorectal surgeon for further investigations.
- Physical Examination – The specialist doctor will examine your anus & surrounding area for physical signs of fistula. Openings of fistulas generally appear as red & swollen spots oozing pus. The doctor is usually able to work out the path of the fistula if the opening is located. In many instances the path of fistula can be felt as a hard cord type of structure beneath skin.
- Rectal Examination – The specialist doctor may also perform a rectal examination in order to locate the internal opening of fistula. Doctors may also check if there are any secondary tracts branching off the fistula. Rectal examination which involves probing the anal canal with a finger will help the doctor determine the type of treatment which is required in a particular case.
- Proctoscopy – Proctoscope basically is a special medical telescope with a light on the end. The specialist doctor may use this device to look inside the rectum. They may also use another device for fistula probe. Fistula probe involves a tiny instrument which is inserted through the fistula. However, both these examinations are performed under the influence of general anesthesia where the patient will be asleep & will not feel a thing.
Further Tests – You may need to undergo further tests if you are having a complicated fistula with several branches. This is meant to determine the exact position of fistula tracks. Additional tests which may be required include –
- Anal Endosonography (Ultrasound)
- Magnetic Resonance Imaging (MRI Scan)
- Computerized Tomography (CT) Scan
Treating Anal Fistula
Since anal fistulas rarely heal without treatment, they usually require surgical intervention. Surgical options which are available as treatment depend upon the location of fistula & whether it is simple or a complex problem. Risk of complications following conventional anal fistula surgery, include infections, bowel incontinence & recurrence. Some of the most common surgical interventions as treatment for fistula include the following.
- Fistulectomy – This is the most common method of treating anal fistula. However, it takes about one or two months’ time for fistula to completely heal following fistulectomy.
- Coring of Fistula – A deep dissection is created during this procedure around the fistula & the tract removed from the digestive system.
- Seton Techniques – This procedure involves leaving a piece of thread within the fistula tract. Seton is usually considered for patients who are at high risk of incontinence due to fistula crossing sphincter muscles.
- Advancement Flap Procedures – Complex fistulas or high risk of incontinence usually call for this procedure. A piece of tissue is removed from skin around anus & attached to the opening of fistula. Advanced flap procedure is effective in about 70% of all fistula cases.
- Fibrin Glue – Injecting glue in fistula to seal the tract & stitching close the opening is performed during the operation. Fibrin glue procedure is safe, simple & painless but is not effective for long.
- BioProsthetic Plug – This involves making a cone shaped plug from human tissue in order to block the internal opening of fistula. However, this procedure is not perfect & the fistula may still drain. Although new tissue can grow around the plug in time, success of this method is still uncertain.
Advanced Laser Ablation Treatment for Anal Fistula
Laser treatment for anal fistula is a nonsurgical procedure which involves no cutting, no incisions or any need for dressing. Patients are back to normal the very next day. During this procedure doctors identify the tract & clean them. Subsequently, laser beam is induced into the tract in order to close them. There are 5 state-of-the-art Laser Piles Clinics in Hyderabad offering advanced laser treatments for anal fistulas at affordable costs. For quick & effective results, visit the nearest Laser Piles Clinic located near you.
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