Anal Fistulas – What They Are, How To Treat Them & What Your Doctor Needs to Know

The last portion of the gastrointestinal system is the anal canal. It consists of the rectum as well as the anus. The anus is the body’s external orifice to pass feces. 

There are some instances in which an aberrant channel develops from the anal canal to the skin close to the anus. This condition is referred to as an anal fistula. It is also possible for the anal canal to develop a fistula that connects to other organs, such as the vagina or the urinary system.

What Does Your Doctor Need to Know?

A doctor needs to know the following about the patient:

Whether the patient,

• has had a history of constipation or passage of hard stools,
• has the presence of blood on the surface of stools along with frequency,
• has rectal pain while passing the stool,
• witnesses that blood is visible on the toilet paper after wiping,
• has frequent anal abscesses,
• has irritation of the skin around the anus from drainage,
• has pain with bowel movements.

How Is an Anal Fistula Detected?

Your doctor will examine the region around the anus. It is often sufficient to identify an anal fistula. On the patient’s skin, they will search for an opening known as the fistula tract. Thereafter, the doctor will assess the tract’s depth and path.

It is likely to notice drainage coming from the exterior hole in many instances. The doctor uses gentle pressure on the fistula to determine the presence of bloody discharge and discomfort.

To determine whether the illness is connected to Crohn’s disease, an inflammatory disease of the digestive tract, your doctor may suggest further tests. Fistulas affect around one-quarter of those who have Crohn’s disease.

In this situation, your doctor may need to do further tests, including the following:

Magnetic Resonance Imaging (MRI) Scan

The imaging scan uses strong magnetic and radio waves to generate detailed pictures of the scanned organ. This approach is often used in the event of a recurrent fistula or one that is very complicated.

Proctoscopy

This procedure uses a fistula probe attached to a specialized telescope to examine the rectum. The process known as proctoscopy is often carried out while the patient is under the influence of general anaesthesia.

CT (Computed Tomography) Scan

The CT, also known as the computerized tomography scan technique, is used to create in-depth cross-sectional pictures of the body by combining a sequence of X-rays with a computer. This technique is also helpful in accurately assessing the level of inflammation that is present.

Colonoscopy

During a colonoscopy, a lighted, flexible tool is passed through the anus to examine the colon’s internal lining. It is done while the patient is under conscious sedation, which is a sort of mild anaesthesia.

Anal Ultrasound Or Endosonography

Anal Endosonography, also known as Anal Ultrasound, is a process that utilizes high-frequency sound waves to obtain pictures of the region below the surface of the anal canal. It is relatively risk-free compared to the other operations and tests.

What Are the Options for Treating an Anal Fistula?

Surgery is usually required to treat an anal fistula successfully. A specialist in colon and rectal surgery will carry out the procedure. Fistula removal is done with the protection of the anal sphincter muscles to avoid injury and subsequent incontinence. The fistula is opened to make it possible to heal from the inside. 

Seton placement

In this technique, a suture or rubber band (seton) is inserted into the fistula and gradually tightened until it closes. Incontinence risk may be minimized by allowing healing behind the seton.

Collagen plug and fibrin glue

Sutures seal the hole’s interior surface once the surgeon cleans the channel. A fibrin-based special glue is then administered into the fistula’s external entrance. As another option, the anal fistula tract may be closed and sealed with a collagen protein plug.

Ligation of the intersphincteric fistula tract (LIFT)

The LIFT treatment is a two-stage therapy for fistulas that are more difficult to treat or more profound in the body. The LIFT process ensures that the internal incision is securely closed and removes contaminated cryptoglandular tissue via an intersphincteric method.

Advancement rectal flap

The surgeon must generate a flap from the rectal wall to close the fistula’s internal entrance. After that, the flap is utilized to cover the repaired area. The quantity of sphincter muscle that has to be severed during this treatment can be decreased.

Conclusion

In extreme situations, fistula tract mapping and identifying internal apertures may be challenging tasks. A wide range of cutting-edge imaging techniques is used by the specialists of the Max healthcare group, including fistulometry, endoscopic ultrasound, flexible sigmoidoscopy, and magnetic resonance imaging (MRI).