What is Anal Fistula?
An anal fistula is a small tunnel/channel created unusually under the skin. This tunnel links the anal canal (at the bowel end) to the buttock’s skin. It has a tract with two openings. One opening is into the rectum or anal canal and the other is external, through the buttock’s skin. At Sree Nandaka Advanced Surgery Clinic the best Anal Fistula Surgery in Hyderabad is provided by experts using the minimally invasive and advanced surgical techniques for safe and effective treatment of anal fistula. For best anal fistula treatment, book an appointment with Sree Nandaka Advanced Surgery Clinic.
Types of Anal Fistula
Based on where the fistula tract is created, the anal fistula is of the following four types:
- Inter-Sphincteric- A track is created in between the anal sphincter muscles.
- Trans-Sphincteric- A track passes through both the anal sphincter muscles.
- Supra-Sphincteric- A track loops over the anal sphincter muscles and passes through the muscles of the pelvic floor.
- Extra-Sphincteric- A track runs from the rectum to the skin and does not involve anal sphincter muscles.
Causes of Anal Fistula
Almost all anal fistulas are the result of an infection in one of the glands near the anal opening that leads to pus build-up in the nearby tissue (called anorectal abscess). When this pus gets drained away, there is incomplete healing of the abscess. This may lead to the formation of a small channel called a fistula.
Other causes include:
- Malignancy in the anorectal area
- Medical conditions that lead to intestinal inflammation such as Diverticulitis and Crohn’s disease
- Sexually transmitted diseases, tuberculosis, HIV infections
- A complication of previous surgery in the anorectal region.
Symptoms of Anal Fistula
Anal fistula is typically associated with the following symptoms:
- Irritated skin around the anus
- A constant, throbbing anal pain that worsens while sitting down, moving around, defecating, and coughing or sneezing
- A foul-smelling discharge of pus, debris, and blood from near the anus
- Redness, swelling, itching, or tenderness around the anus
- Fever.
Diagnosis of Anal Fistula
Usually, anal fistula can be diagnosed by going through the patient’s reported symptoms and past medical records followed by a clinical examination involving a digital rectal examination. During examination, a proctoscopy may be performed to inspect for any concomitant condition in the patient’s rectum.
In case of complicated fistulas with challenging delineation of the tracts, an MRI fistulogram may be recommended to confirm the diagnosis of fistula. Now advanced imaging of the rectum and anal canal is possible with 3D- Endo-anal imaging technique. This technique can be employed as a diagnostic tool for anal fistula as it can best visualise the tracts and study the features of fistula.
Treatment of Anal Fistula in Hyderabad
Antibiotics alone cannot help treat anal fistula. Rarely can a fistula heal on its own. Cure of persistent anal fistula is only possible with surgical intervention.
The treatment options for anal fistula include:
- Fistulectomy- This surgical approach involves complete excision of the fistula tract and the groove formed is left to heal. It is preferred in case of complex fistula and it is associated with a risk of damage to anal sphincter muscles as well as faecal incontinence.
- Fistula filling with special glue or plug- The procedure involves closing the inner opening of the anal fistula with a synthetic bioabsorbable scaffold called a plug. Its advantage is that there is no excision involved and no damage to anal sphincter muscles.
- Seton placement- The procedure involves placing and progressive tightening of a seton (rubber band or suture) in the tract of the fistula. The fistula is left to heal behind the placed seton. This reduces the risk of faecal incontinence.
- Ligation of Intersphincteric Fistula Tract- This procedure is carried out for deep and complex fistulas. Firstly, the surgeon places a seton (rubber band or suture) in the fistula tract to make the tract wider over time. A few weeks later, the surgeon takes out the infected material from the fistula tract and closes the opening of the internal fistula.
- Distal Laser Proximal Ligation- This procedure involves excision of any anorectal abscess cavity along with internal opening and then closure of the distal fistula tract. The proximal region of the fistula tract is further sealed using a laser. At the end, the fistula tract is entirely closed.
- Fistula tract Laser Closure (FiLAC)- This is an advanced, minimally invasive surgery where the fistula tract is gently removed using a laser without harming the anal sphincter muscles. The procedure involves the insertion of a laser fibre emitting a defined amount of laser energy circumferentially into the fistula tract. It causes controlled thermal injury to the fistula tract leading to its collapse. The photothermal destruction even helps support and facilitate the natural healing of the fistula. Laser surgery for fistula in Hyderabad is considered to be one of the modern treatments for fistula management.
This is so far the best anal fistula treatment that can be performed on all kinds of fistulas even in elderly people and patients who have heart issues and hypertension. It even preserves the anal sphincter muscles and prevents faecal incontinence. For more details get in touch with the Best Doctors For Anal Fistula in Hyderabad at Sree Nandaka Advanced Surgery Clinic.
FAQS on Fistula Treatment
When can I go home after my fistula treatment?
In case you are going for a daycare surgery, you can return home as soon as the anaesthesia effect wears off, you have passed urine, and you are comfortable eating or drinking. If you have undergone your surgery under general anaesthesia, you will need a responsible adult to take you home and take care of you for at least 24 hours. You may have to stay in the hospital overnight and before you get discharged, you will receive at-home post-surgery instructions and prescription medications.
Do I need to have a specific diet plan before and after my anal fistula treatment?
You don’t require any specific diet plan. However, you are advised to strictly follow a healthy, fibre-rich diet both before and after your anal fistula surgery.
What can I do to encourage successful healing of my anal fistula?
You will have to take plenty of rest, Take Sitz Bath after every bowel movement, and have a healthy diet rich in fibre. Moreover, you should maintain hygiene as well as good washroom habits.
When should I seek anal fistula treatment?
If your anal fistula is causing a lot of pain and discomfort which can’t be relieved with prescription medications; or you are experiencing bleeding during bowel movement; or you are down with high fever; and/or you have persistent nausea or vomiting, you should seek treatment of your anal fistula from a proctologist.
How long does it take for anal fistula to heal?
Complete healing of anal fistula usually takes 6-8 weeks. Normal routine activities and travelling can be resumed by the patient within about one week of receiving the treatment.
Who is more likely to get anal fistula?
Anal fistula is very common in patients suffering from anal abscess, Crohn’s disease, Colitis, chronic diarrhoea, and radiation treatment for rectal cancer.
Schedule an Appointment with Fistula Doctor
Not able to get relief from anal fistula with home remedies and non-surgical therapies? Our top-notch proctologists and anorectal surgeons at Sree Nandaka Advanced Surgery Clinic, Best Clinic for Anal Fistula Treatment in Hyderabad can help with the surgical treatment of your anal fistula, ensuring complete relief, at an affordable price.
Sree Nandaka Advanced Surgery Clinic is a certified, centre of excellence in fistula surgeries and care in Hyderabad. To date, thousands of patients with fistula, including those having complicated fistula and fistula recurrence have been successfully operated on by our specialists. Our success rates have also been seen in rare cases of anal fistula like those extending from rectum to groyne, rectum to abdomen, and rectum to tailbone.
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