An anorectal fistula is a tract or a channel which develops an internal opening in the anus and external opening to the gluteal region in the form of boils. There is continued pus discharge from this boil. This tract is becoming more inflamed or infected during the time. There is no cure for fistula by medication if someone develops fistula, the surgeon has to excise the whole infected tract with different methods.
Causes and symptoms of anal fistula:
- Old rectal injury
- Infection of sphincter muscles
- Anal abscess
- Crohn`s disease
- Anorectal region Malignancy.
- Infections-Tuberculosis, HIV, Sexually transmitted disease.
- Previous surgery complication.
Symptoms of anal fistula:
- Prickling pain in the anal region
- Pain during defection/ passing motion
- Fragmented Pus discharge for the boil or anal region
- Inflamed tract feel by hand
- Pain during long sitting
- Boil near anal region
- Fever due to infection
Diagnosis of anal fistula:
Usually, fistula easily diagnosed by rectal examination with transparent scope (proctoscope). In the proctoscopy, examination surgeon inserts the proctoscope to the patient anal region. And check for the internal opening of the fistula tract or any other anorectal problem. Sometimes multiple fistula tracts are not examined by proctoscopy but then doctors do MRI pelvic of the patient to find out multiple tracts, which are easily shown in MRI reports.
Classification of anal fistula:
There are 4 types of Fistula:
- Intersphincteric– Most common fistula in people occurs due to perianal abscess. This tract crosses the internal sphincter to intersphincteric space and comes out to perineum. There is no involvement of external sphincter.
- Transsphincteric-Transphincteric tract crosses both internal or external sphincter then comes out to the perineum.
- Extrasphincteric-This tract passes from the rectum and levators muscles to the perineal skin.
- Suprasphincteric-This fistula tract is usually developed by supralevator abscess. This tract arises in intersphincteric space.
Surgery for anorectal Fistula:
- Fistulectomy- Excise the whole fistula tract.
- Laser Coagulation of fistula ( LCF)- In this surgery, the surgeon inserts the fistula probe into the external opening, and give some amount of energy to coagulate the fistula tract, there will be no cuts and wound in this procedure.
- Ksharsutra treatment for fistula- In this method, a special thread (ksharsutra) is used to cure the fistula. By inserting the herbal chemical cauterization thread into the whole fistula tract.