A fistula is an abnormal, tube-like connection, a passage or hole that forms between two organs or an organ in your body and your skin. There are various types of fistulas that can develop in different parts of your body but the most common types are-

1. Obstetric Fistulas: This is the name given to a hole between the vagina and rectum or bladder. A vaginal fistula that opens into the urinary tract is called a vesicovaginal fistula and one that opens into the rectum is called a rectovaginal fistula. 

A woman with obstructed labour or labour that is not attended by a doctor or a midwife, can suffer labour pain for up to six or seven days. And as the labour produces contractions that push the baby s head against the mother s pelvic, the soft tissues between the baby s head and the pelvic bone are compressed and do not receive adequate blood flow between the mother s bladder and vagina and/or between the rectum and vagina.
This means that a hole forms on the vaginal wall between the urinary tract and her rectum. The urine and faeces thus start to leak from the vaginal opening causing soiling and foul smell.

Apart from labour, hysterectomies that damage the vaginal wall can also cause such types of fistulas.

Enterovaginal   A woman may have gas and foul smelling fluids leaking out of her vagina due to an enterovaginal fistula which is a hole between the vagina and the digestive tract. It s usually caused due to inflammatory bowel disease or IBD and ulcerative colitis.

2. Anal fistula

These are fistulas that form between the end of the bowel and skin near the anus.

An anal fistula usually develops due to a previous or current anal abscess. An anal abscess is an infected cavity filled with pus found near the anus due to an acute infection in the internal glands of the anus.

Common symptoms are:

Pain in the anorectal area
Swelling
Redness
Fever
Rectal bleeding
Urinary symptoms, such as trouble initiating urination or painful urination
Causes:

Inflammatory bowel disease   a chronic condition of the GI track which causes inflammation
Diverticulitis   An infection in the large intestine
Tuberculosis, HIV
Surgery near the anus
Anal abscess and likewise anal fistula are treated by surgical drainage in which an incision is made in the skin near the anus to drain the infection causing an anal abscess. Hospitalization may be required for patients who have impaired immunity like diabetics.

Anal fistula though has no medical treatment and surgery is almost always necessary to cure it.

If the fistula is straightforward which means one that involves minimal sphincter muscle, a fistulotomy may be performed. This involves cutting open the whole length of the fistula so it heals.
Seton is another procedure in which a surgical thread called a seton is placed in the fistula and left there to help it heal.

Different Types of Fistula and Treatments!

Haemorrhoids or piles is a condition where the veins in and around your anus become swollen. This swollen vein sticks out from the anus and can make sitting and moving difficult. Laser haemorrhoidoplasty is one of the best ways to treat advanced forms of the condition. However, before knowing more about the procedure, you should learn more about piles in general.

Causes of piles-
You are likely to develop piles in the following events  
  If you strain excessively during bowel movements
  If you sit for prolonged periods on the toilet
  If you suffer from constipation or chronic cases of diarrhoea
  If you are overweight or obese
  If you are pregnant
  If you engage in anal sexual intercourse
  If your diet lacks proper quantities of fibre
The likelihood of having piles increase with your age. This is because the tissues supporting your veins tend to lose their strength, as you grow old.

Symptoms of piles-
If you suffer from piles, you can easily notice certain symptoms from the condition. Here are the most common signs of haemorrhoids  
  You will notice bleeding during bowel movements. However, you will not feel any pain from the said bleeding.
  Your anal and rectum area will itch throughout the day. You will experience irritation in the region as well.
  You will notice a lump formation near the anus, which will lead to extreme pain and discomfort. Sitting and walking may also become painful due to the presence of the lump
  You may also notice a general swelling in your anus region.
However, the exact symptoms may vary from one affected person to the next, based on the location and type of haemorrhoids.

How does laser haemorroidoplasty help in the treatment of piles?
While most haemorrhoids are treated with medication and lifestyle changes alone, advanced cases require additional procedures. Laser haemorrhoidoplasty is one such procedure used to treat severe piles cases.
This treatment results in the reduction of the size of the haemorrhoid. The laser energy passes through the haemorrhoidal node, destroying it in the process.

Here are some advantages of laser haemorrhoidoplasty  
  Closes the arteries carrying blood inside the haemorrhoid
  Reduction of the haemorrhoidal node tissues
  Preservation of most of the mucosa, anal lining and muscle
  Rectifies the issues with the anatomical structure and restores it to normal
  A minimally invasive procedure, which limits post-operative pain and scarring

If you suffer from an advanced stage of piles, speak to your doctor and see whether laser haemorrhoidoplasty is an option for you.

Laser Haemorrhoidoplasty - What All Should You Know About It?

Anal Fistula is a tunnel like communication structure between anal canal and outer skin. There are certain glands in anus whose secretions keep the anal passage lubricated. If due to any reason infectious agent invades these glands abscess formation occurs which subsequently spreads towards the skin and bursts outside forming an external opening.

So Anal Fistula presents itself as a nodular swelling in area surrounding anal opening. Intermittent pus discharge is seen from this swelling. When pus has accumulated there will be swelling and pain which subsides once the pus has been discharged and this cycle goes on.

Anal Fistula Treatment:

Anal Fistula cannot be treated by oral medicines only - Homeopathic/ Allopathic or Ayurvedic whatever it may be. Continuing oral medicines in hope for fistula treatment only worsens the problem. Different surgical options have been tried to treat Anal Fistula like Fistulectomy/ VAAFT/ Laser/ LIFT etc. but not satisfactory results have been found. A high incidence of recurrence around 20-25 % has been observed with these procedures. 

Besides this other complications like stool incontinence etc. are also seen if there is some damage to sphincter muscles. However Anal Fistula can be completely treated by Graded KsharsutraTM Treatment. Clinical trials conducted by Indian Council of Medical Research (ICMR) at AIIMS new Delhi; PGI Chandigarh and other premier institutes of medical sciences; have proved that Ksharsutra treatment is more convenient and more effective than Surgery in patients suffering from Anal Fistula.

In this treatment; first of all Fistula tract is defined with respect to depth, direction and branching pattern by careful manual probing and MRI Fistulogram. Once the Fistula tract has been defined properly; Graded KsharsutraTM - a specialized medicated thread is placed in Fistula tract. Medicine released from KsharsutraTM debrides the Fistula tract and induces healing. This medicine works for 5-7 days so old Ksharsutra needs to be replaced by a new thread at week or 10 days interval.

No. of Ksharsutra changes required for complete healing of Fistula depends on length of Fistulous tract. It has been observed that a Fistula tract of 3 cm length usually requires 4-5 Graded KsharsutraTM sittings at weekly intervals for complete healing. Thus with this recent concept of Graded Ksharsutra treatment of Anal Fistula has become more easy and more effective.

Anal Fistula - How Non Surgical Treatment Is Better Than VAAFT/Surgery?

An anal fissure or fissure-in-ano is a small, cut in the skin in anal passage which results because of trauma to skin by passing hard stool in this region. Sometimes pain is so severe that patient tends to avoid passing stool in an attempt to stay away from pain.

Symptoms of Anal Fissure: 

  Pain in anal region while passing stool; it may be burning/pricking/Itching in nature.

  Bleeding may or may not be there.

  If untreated for long time; a skin tag known as Sentinel tag or Sentinel Piles develops from the lower end of fissure.

Causes 

The causes related to the emergence of an anal fissure include:

  Passing hard stool which causes frictional injury to inner lining of anal passage.

  Repeated bowel movement or diarrhea

  Trauma to anal canal like by enema nozzle 

Why non surgical treatment is better than Surgery:

Usually surgery (Lateral sphincterotomy) is advised in a view to relieve spasm in anal region so that Fissure starts healing but there are certain complications like stool incontinence etc. associated with this procedure which makes non surgical approach better than surgical intervention. Some of the reasons which make non surgical approach better than surgery for anal fissure are as follows: 

  Acute anal fissure can be conveniently treated by Graded Kshar Karma Treatment. In this treatment a specialized Ayurvedic medicine is applied in fissure region which debrides the fissure and promotes healing. In this way fissure heals completely. So, no need for any surgery at this stage and thus no complication like bleeding, pain, stool incontinence, etc.

  When Fissure is not treated at this stage; a skin tag known as sentinel piles develops from the lower end of fissure. This condition also can be managed by Graded Ksharsutra TM Treatment. In this treatment, Graded Ksharsutra TM - a specialized medicated thread is ligated at the root of sentinel piles and sentinel tag gets detached in 3-5 days. No hospitalization or bed rest is required in this treatment. So, at this stage also fissure can be managed without surgery.

  Delayed healing and Recurrence of Anal fissure are other complications seen after Anal Fissure surgery. Such complications are not seen in Graded Kshar Karma and Ksharsutra Treatment.

  In some case stool incontinence (inability to hold stool; which is far worse than Anal fissure itself) is also seen after Anal Fissure surgery. However, there is no harm to stool control in Graded Kshar Karma and Ksharsutra Treatment.

  No hospitalization or bed rest is required in Graded Kshar Karma and Ksharsutra treatment. Hospitalization and bed rest for a considerable time period is necessary in surgery.

  Graded Kshar Karma and Ksharsutra are more economical than surgery. With this discussion; it is for sure that non surgical treatment for Anal Fissure is far better than Surgery.

Anal Fissure - Non Surgical Treatment Is Better Than Surgery!

AV or arterio-venous fistulas are unusual linkages between arteries and veins. In general, pure blood passes from the arteries to the capillaries to the veins and becomes devoid of nutrients and oxygen (becomes  impure ) by the time it reaches the veins. The capillaries in between absorb the nutrients, to supply them to the tissues and organs lying beneath them. In the case of AV fistulas, the capillaries are bypassed and blood passes directly between the arteries and the veins. Thus, organs are deprived of nutrients.

This can be a severe condition, leading even to heart failure.

AV fistulas and dialysis

Sometimes, AV fistulas have to be deliberately created on the body, to treat for severe kidney ailments requiring dialysis.

What is the surgical procedure for creation of AV fistulas for dialysis?

Following are the steps-

  A vascular specialist checks your arteries and veins to make sure they are sturdy enough to be able to support an AV fistula.
  Then, with the help of wave techniques or an angiogram, the depth of your blood vessels is recorded.
  Anaesthesia is then used on the spot, which is chosen for your AV fistula. Local anaesthesia (anaesthesia of only that spot) is preferred over central anaesthesia (anaesthesia of the whole body).
  With the help of a small cut on the skin surface, the surgeon accesses your blood vessels and makes a connection between arteries and veins.

After this process is completed, dialysis takes usually some weeks to begin.

Why should you go for AV fistula?

Following are the advantages-

  Foreign chemicals or devices, which may cause invasion and damage to vital internal organs, are not introduced in your body.
  As only local anaesthesia is administered, you have to spend significantly less recovery time or  downtime  after surgery.
  There is less chance of the wound becoming infected.
  There is a reduced danger of clotting.

AV fistulas are in essence an unusual connection between your arteries and veins, leading to undernourished organs due to capillaries being bypassed. In some cases like dialysis, AV fistulas need to be created and closely monitored. There are several advantages to this, but you will also need recovery time after the procedure is over.

AV Fistula - Its Surgery & Creation Of AV Fistula For Dialysis!

Hemmorroids can be really uncomfortable and keep you in pain all through the day. One of the best and fastest way to get relief from this condition is to get them removed for good which can be easily done with the help of the surgery. The recovery period after a hemorrhoid surgery typically varies from one to two weeks depending on a host of aspects such as severity of hemorrhoids, the number of hemorrhoids as well as the type of treatment. During this span, a certain level of pain and discomfort is expected, but with some useful care tips, you can get some relief within a few days after the surgery.

Making lifestyle changes: After the surgical intervention, the patient must be on bed rest for a week or so. This is because, during this time, the surgical wounds can reopen at any time if caution is not exercised. If you have excessive body weight, it is recommended that you should lose weight after this surgery. This must be done healthily so that the stress is reduced in the rectum area while an individual squat or sits down. This could lead to the recurrence of hemorrhoids in the long run. After the first few weeks, the patient must take a 10-minute brisk walk regularly.
Take painkillers: In case the pain from hemorrhoids worsens after the surgery, you may consider taking painkillers. Many patients tend to use these medications to recover from hemorrhoids surgery, and you should take only prescription drugs only.
Keep up with a healthy diet: You should make it a habit of eating a high-fiber diet and taking adequate amounts of fluid every day. This will not just accelerate the recovery process but prevent the recurrence of hemorrhoids. For best results, this should be practiced a few weeks before and after the surgery.
Try different home remedies: In addition to the common methods of easing pain and discomfort after hemorrhoids surgery, you may also try different types of home remedies. Make sure that the wound is always clean and you can also use gels and creams for minimizing irritation.
Alleviate itchiness: During the hemorrhoid surgery recovery, you are likely to experience itchiness which is a characteristic of a recovery period. This is a common symptom of external hemorrhoids, and to reduce it, you can take a sitz bath. Your doctor may also prescribe a topical medication depending on the location and severity of the problem.
Educate yourself about the surgery and post-operative care: This is presumably the most important aspect of caring for hemorrhoids surgery. You should learn about the common complications of this surgery and how you can overcome them.
Know when you can call a doctor: During the recovery process, it is critical to follow the instructions as given by the doctor. You should maintain the follow-up treatment with your doctor so that you can report him of any health problems and discomfort to take required steps.
With care and caution, you may recover easily from hemorrhoid surgery and return to normal life soon.

Hemorrhoids Surgery - 7 Tips To Help You Recover!

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