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Overview of anus fistula and its treatment

Last updated on : 16 May, 2024

Read time : 7 min

What is an anus fistula?

The last part of the digestive system is the anal canal. It’s made up of the rectum and the anus. From the anal canal to the skin near the anus, an abnormal passage can sometimes form. This is called an anus fistula.

Anus fistulas can also connect the anal canal to other organs, like the urinary tract or the uterus. Fistula symptoms include swelling and pain around the anus.

An anus fistula links the vagina to:

  • Ureter
  • Urethra
  • Rectum
  • Bladder
  • Colon
  • Small intestine

Types of fistulae

1. Anus fistula

The uncharacteristic connection between the epithelial surface of the peritoneal skin and the anal canal.

  • Rectovaginal fistula
  • Colovaginal fistula
  • Anorectal fistula
  • Anovaginal fistula

2. Urinary tract fistula

Irregular opening within the urinary tract or between urinary tract organs.

  • Vesicovaginal fistula
  • Vesicouterine fistula
  • Urethrovaginal fistula

3. Other fistula types

  • Enterocutaneous fistula
  • Enteroenteral fistula
  • Colocutaneous fistula

If these types of fistulas are left untreated, fistulas can be debilitating, harmful, and even traumatic. Sometimes kidney damage, nerve damage, and infections are also associated with fistula.

Fistula Symptoms

Symptoms depend on the type of fistula which are included over here:

  • Diarrhoea
  • Urinary tract infections
  • Regular urine leakage from the vagina
  • Abdominal pain
  • Irritation in female genital organs
  • Vomiting
  • Leakage of faeces in the vagina
  • Swelling around anus
  • Bleeding

If you have one or more of these anus fistula symptoms, make sure to discuss them with your doctor as soon as possible and have a treatment.

Anus fistula causes

The leading cause of an anus fistula is clogging of anal glands and abscesses. Abscesses are a condition that develops due to bacteria build-up in the anus which causes swelling of the infected tissue. Abscesses if not treated can even grow, and cause a fistula.

Some other common conditions that can cause fistula:

  • STDs (Sexually transmitted diseases)
  • Chron’s disease
  • Cancer
  • Tuberculosis
  • Exposure to radiation
  • Trauma
  • Diverticulitis

Anus fistula treatment 

For treatment of fistula disease, patients must visit the hospital. The doctor will diagnose which type of fistula disease is and decide the best treatment plan based on size, location, and condition.

Generally, the treatment involves controlling symptoms with the help of a catheter, but severe fistula disease may even require surgery. Surgery is performed by a rectal or colon surgeon. Anus fistula surgeries do not last long, the patient can go home on the very same day.
But, in the case of a complex fistula, where the surgeon has to place drainage called a seton. Which kept intact for at least 6 weeks.

1. Fistulotomy

A fistulotomy is the type of surgery that is most often done to fix an anal fistula. To do this, a cut is made along the length of the fistula to open it up and let it heal as a flat scar.
A fistulotomy is the best way to treat many anal fistulas, but it usually only works for fistulas that don’t go through much of the sphincter muscles, even though in these the risk of incontinence is lowest. If the surgeon has to cut a small piece of the anal sphincter muscle during the procedure, they will do everything they can to lower the risk of incontinence.
If the chance of incontinence is thought to be too high, a different procedure may be suggested instead.

2. Seton techniques

If your fistula goes through a big part of your anal sphincter muscle, the doctor may suggest putting in a seton at first. A seton is a piece of surgical thread that is left in the fistula for several weeks to keep it open.

This lets it drain and helps it heal without having to cut the muscles of the sphincter. Fistulas can drain when setons are loose, but this does not heal them. For a fistula to heal, tighter setons may be used to cut through the fistula.

This may need more than one procedure, which the physician can talk to you about. Or, they may suggest doing more than one fistulotomy, opening up a small part of the fistula each time or a different treatment.

3. The advancement flap procedure

If your fistula goes through the muscles of the anal sphincter and a fistulotomy is likely to make you incontinent, you may for an advancement flap procedure.
This is done by cutting or scraping out the fistula and covering the hole where it went into the bowel with a flap of tissue from the rectum. Which is the last part of the bowel. This work is less likely than a fistulotomy, but the muscles of the anal sphincter don’t have to be cut.

4. LIFT (Ligation of the intersphincteric fistula tract) treatment

The ligation of the intersphincteric fistula tract (LIFT) procedure is used to treat fistulas that go through the anal sphincter muscles when a fistulotomy would be too dangerous.
During the treatment, a cut is made in the skin above the fistula, and the sphincter muscles are pulled apart. The fistula is then closed at both ends and cut open so it lies flat. This procedure has had some impressive outcomes so far, but it’s only been around for a few years.

5. Bioprosthetic plug

Another thing is to put a bioprosthetic plug in the hole. This is a plug made of animal tissue in the shape of a cone. It is used to block the opening of the fistula. This method works well to close an anal fistula, and there aren’t any major safety issues about it.

6. Medication

Antibiotics may be useful in treating any infection related to fistula. But, there is no medicinal solution to eradicate anus fistula.
In some cases, where the fistula is not too deep Fistulotomy can be performed. In this, the fistula tract is opened to allow it to heal from the bottom.

Surgery is often accompanied by antibiotics and is effective in treating abscesses. Since it is believed that the fistula can come back. Hence it is always advised by the doctor to take proper care, post-surgery and also have some natural home remedies treatment for fistula.

Complications of Fistula

  • Sepsis is a life-threatening condition that arises due to a bacterial infection that can spread throughout the body.
  • Sometimes, an intestinal fistula may cause infection in the peritoneum cavity. 
  • The fistula causes painful abscesses and discharges foul-smelling fluid.
  • Perforation

How to manage anus fistula by ourselves

When you want to recover from fistula treatment make sure that you take your medications as directed by your doctor. Complete all your antibiotics, even if you’re feeling better. Don’t take any over-the-counter medicines without consulting your doctor.

Other important instructions may include:

  • Soak in a warm bath 3 to 4 times a day
  • Wear a pad under your panty until it gets healed.
  • Going back to normal activities only when your doctor says you can
  • Eating a high-fibre diet and drinking plenty of fluids
  • Use a stool softener or bulk laxative as you need.

How to prevent anus fistula

Fistula can’t be avoided, but you can reduce your chances of getting more risk by doing the following thing:

  • keeping the anus dry
  • The anus area was cleaned with warm water and mild soap.
  • To avoid constipation, you should drink a lot of water, eat foods with fibre, and exercise.
  • Taking care of diarrhoea straight away
  • If an infant has the condition, they will need to have their diapers changed.

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Disclaimer

Our healthcare experts have carefully reviewed and compiled the information presented here to ensure accuracy and trustworthiness. It is important to note that this information serves as a general overview of the topic and is for informational purposes only. It is not intended to diagnose, prevent, or cure any health problem. This page does not establish a doctor-patient relationship, nor does it replace the advice or consultation of a registered medical practitioner. We recommend seeking guidance from your registered medical practitioner for any questions or concerns regarding your medical condition.

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