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Anal fistula

An anal fistula is a small channel that can develop between the end of the bowel (anal canal) and the skin near the anus. It appears as a hole in the skin around anus and causes pain, bleeding and discharge while passing stool. It can cause persistent drainage in some cases and may result in recurrent anal abscesses.

Anal fistula can be simple if there is single fistula or complex in case of interlinking fistulas. It can be low or high depending upon its position and closeness to sphincter muscles.

Causes of Anal Fistula

Almost all anal fistulae are a result of an unhealed or partially healed anorectal abscess after drainage. It can also be caused by other intestinal conditions like:

  • Inflammatory bowel disease (IBD)
  • Diverticulitis
  • Crohn’s disease
  • HIV
Symptoms of Anal Fistula

The cardinal symptom of anal fistula is persistent drainage from an acute abscess due to chronic, low grade sepsis (infection) even after its treatment. Other than this, anal fistula may also show following symptoms in an individual:

  • Irritation and itching around anus
  • A throbbing and constant pain that becomes worse on sitting, moving,coughing or having a bowel movement
  • Swelling, redness and tenderness around anus
  • Pus or blood discharge on bowel movement
Diagnosis of anal fistulas

Physician carefully records the patients complaints and history. This is followed by a digital rectal examination which may be done under anesthesia in the operating room. In most of the cases, identification of an external and internal opening on the perianal skin and anal canal confirms the diagnosis. But some cases may require additional examinations like an ultrasound, a CT scan or an MRI to confirm the diagnosis of anal fistula.

Treating an anal fistula

The only cure for an anal fistula is surgery as they rarely heal on their own. There are several types of surgical methods and the choice depends upon the location of fistula and its closeness to sphincter. The most common type of surgeries are:

  • Fistulotomy
  • Seton techniques
  • Advancement flap procedures
  • Bioprosthetic plug
  • Laser fistulectomy is the most advanced procedure in which the whole tract is excised with a laser.
Advantages of Laser Fistulectomy Procedure performed at Vikrams clinic
  • More effective than open surgical Fistulectomy
  • Relatively shorter treatment time
  • Relatively painless procedure
  • Relives the patient discomfort
  • Patient can return to normalcy in a few days time
  • Lesser chances of infection