Fistula - Must Know Facts About It!

Fistulae are classified into five types, depending upon their relationship with the internal and external sphincter muscles. Extrasphincteric fistulae begin at the rectum or sigmoid colon and open into the skin around the anus. Suprasphincteric fistulae begin between the internal and external sphincter muscles and open an inch or more away from the anal opening. Transphincteric fistulae begin between the internal and external sphincter muscles or behind the anus and open an inch or more away from the anal opening. Intersphincteric fistulae begin between the internal and external sphincter opening and open very near to the anal opening. Submucosal fistulae do not cross either of the sphincter muscle and pass superficially beneath the submucosa.

Anal glands originate from the glands present in the anus. These glands are located between the internal and external anal sphincter which drain into the anal canal. If one or more of these glands become blocked, an abscess can form which may get extended to the skin surface. These abscesses may form a tract, which is called as a fistula.

Surgery is considered to be essential in the treatment of fistulae to allow drainage and prevent infection. However, many patients also opt for leaving the fistulae as it is to get repaired by itself.

Some of the symptoms of anal fistula include skin maceration, pus or serous fluid discharge with or without the presence of blood, itching, and irritability around the anus, pain and swelling around the anus, foul-smelling pus drainage from the anal opening, fever, chills, and fatigue.