The modern lifestyle, along with providing comfort, has also made us susceptible to a host of diseases and ailments. The regular and indiscriminate intake of junk foods, high-salt content foods, and sugar-laden fizzy drinks deprives the body of necessary fiber and essential nutrients. These habits can cause the condition known as the fistula. What more, stress and sedentary lifestyles also figure among the primary causes of the disease.
Fistula can generate extreme pain and bleeding during or after passing stool, blood spots in the stool, and an uncomfortable feeling of something hanging from the anus. The disease can trigger a discharge of pus from the anus or the anal region, along with itching and a burning sensation. Constipation is an associated symptom.
Traditional medicines, such as Ayurveda, recommend the Kshara Sutra treatment which is designed to offer both preventive care and relief from fistula. Kshara Sutra is a minimally invasive surgical procedure which helps patients and Ayurvedic practitioners to manage anorectal diseases. It is a safe and cost-effective means to treat fistula, hemorrhoids, and other similar diseases. Indian sages such as Sushruta and Charaka have attested to the efficacy of such Ayurvedic interventions. In modern times, the efficacy of the procedure has been re-evaluated by the Department of Shalya Tantra in the Benaras Hindu University. The technique is widely practised in India and some other countries.
Patients undergoing Kshara Sutra are anesthetized with either local or general anesthesia. Then a malleable probe is passed through the external opening of the fistula to the internal aperture in the anal canal. The probe is taken out gently through the anal opening along with the Kshara Sutra. Later, both ends of the sutra are tied together. The process is repeated once every week and gradually helps in healing the infected tract.
The treatment helps to cut, drain, and heal the fistulous track which causes the discomfort. It also destroys and helps in the removal of unhealthy tissues, thereby facilitating fast healing of the fistula tract. The Kshara Sutra therapy also controls infection through its microbicidal action. It separates the debris and completely cleans the wound.
Also, this simple and safe para-surgical process is ambulatory, and patient need not stay overnight in the hospital. They may freely pursue their day to day activities immediately after the process is administered. The treatment does not trigger any complications, such as incontinence or stenosis, or strictures. This makes it suitable for patients of all ages.
The procedure being natural, and promises prevention and cure, is recommended to patients that suffer from fistula. However, patients must be advised to seek consultations from trained medical practitioners.
An anal fistula, is also called as fistula- in -ano, it is a small channel that develops between the end of the large intestine called the anal canal and the skin near the anus. This is a painful condition, especially when the patient is passing stools. It can also cause bleeding and discharge during defecation.
Genesis of fistula-in-ano
Almost all anal fistulae occur due to an anorectal abscess that begins as an infection in one of the anal glands. This infection spreads down to the skin around the anus causing fistula-in -ano. The anorectal abscess usually leads to pain and swelling around the anus, along with fever. Treatment for anorectal abscess involves incising the skin over the abscess to drain the pus. This is done usually under local anesthesia. A fistula-in-ano happens when there is failure of the anorectal abscess wound to heal completely. Almost 50% of patients with an abscess go on to develop a chronic fistula-in-ano.
A clinical evaluation, including a digital rectal examination under anesthesia, is carried out to diagnose anal fistula. However, few patients may be advised screening for rectal cancer, sexually transmitted diseases and diverticular disease.
The only cure for an anal fistula is surgery. The type of surgery will depend on the position of the anal fistula. Most patients are treated by simply laying open the fistula tract to flush out pus, called Fistulotomy. This type is used in 85-95% of cases and the fistula tract heals after one to two months.
Other techniques like Fibrin glue and Bioprosthetic plug are also used to surgically treat anal fistulas. In the Fibrin glue technique, glue is injected into the fistula to seal the tract, after which the opening is stitch closed. Bioprosthetic plug is a cone-shaped plug made from human tissue, which is used to block the internal opening of the fistula. After this stitches are used to keep the plug in place.
Whatever the surgical technique, one can experience minor changes in continence. Patients usually don’t require antibiotics after surgery but have to take pain medication. They may also have to use gauze to soak up drainage from anus. After surgery, patients should seek help if they have increased pain or swelling, heavy bleeding, difficulty in urination, high temperature, nausea or constipation.
If you think fissure and fistula are the same, you are mistaken. While the term fissure refers to the tear of the skin, fistula refers to the abnormal tube-like passages or connections between organs. Fissures get cured with or without treatment in a few days to few weeks, and do not lead to complications. On the contrary, fistulas when left untreated may lead to complications.
So, read on further to know about the distinction, how to recognize the symptoms and avail treatment.
What is anal fissure?
An anal fissure can occur due to various reason, such as prolonged diarrhea, anal sex, vaginal childbirth, rectum cancer, etc. For majority of the cases, it is usually due to constant constipation or strained bowel movements, that tear down the muscles controlling the sphincters to the inner rectum or the anal canal.
What is anal fistula?
Anal fistulas are not tears but abnormal abscesses near the anus, filled with pus. In fistula, a tunnel is formed under the skin which connects these abscesses to the infected glands. Fistulas are usually the results of present or previous abscesses. If ignored or left untreated, one single fistula can lead to the development of a more complex fistula, where the single fistula tract ends up creating multiple openings.
Symptoms of anal fissure and anal fistula -
Some of the common symptoms of an anal fissure are excruciating pain in the anal area every time the bowel movement occurs, constant itching or burning sensation in and around the anus, bloody stool and visible tears and cracks around the anus.
For anal fistula, some of the very common symptoms are a throbbing pain in the anus, which continues to increase, difficulty in sitting down for longer period, swelling and redness around the anus, accompanied by skin irritation, discharge of blood and pus, and at times fever.
Treatment options -
To completely cure anal fissure and fistula, it is the various surgical options that are the most effective ones. However, when diagnosed in its earliest form, medications like antibiotics, analgesics, and antipyretics can often help. It is solely depending on the location, type, and size or severity of the fistula or fissure, the treatments may vary from person to person and so does the recovery time.
Though, these conditions cannot be cured with dietary changes or exercise, following a healthy diet can boost healthy bowel movement, reducing chances of constipation or diarrhea that results in fissures.
Prevention is always better than cure. Therefore, it is essential that you visit the nearest medical facilities once you notice any signs of fissure or fistula , to avail the right treatment and get relief from the symptoms quickly.