An anal fistula refers to an infected tunnel that develops right between the muscular opening at the end of the digestive tract (called the anus) and the skin. Anal fistulas are caused by an infection that is present in the anal gland. When the infection stays for a while, it ends up leading to an abscess that is either drained naturally by the body or through a surgery through the skin present next to the anus. As a result the fistula develops between the skin and the infected gland. It can only be treated by surgery.
There are many different treatment options for an anal fistula however all of them require some amount of surgery. A fistulotomy is one such option. You can also have an advancement rectal flap to correct the fistula. Seton replacements are also commonly suggested treatments. You can also have a fibrin glue or collagen plug put in to close the fistula. Lastly, your doctor may also suggest ligation of the intersphincteric fistula tract (LIFT) in order to correct this condition.
The first step to beginning the treatment is to find out the exact path of the fistula. Without knowing exactly where it is or how big it is, the doctors cannot suggest the most effective treatment plan for you. Thus, an MRI will be conducted for them to find out. Sometimes, an endoscopic ultrasound may needed to form a clearer picture. There is also a specific procedure known as a fistulography, which is essentially a high contrast X-Ray of the fistula. Other than these, a fistula probe, anoscope, flexible sigmoidoscopy, or an injected dye solution are also viable methods to find out more about your fistula.
Based on what the doctors find, your treatment plan will be decided. If you are going through a fistolotomy, the surgeons will cut the internal opening of the fistula and scrap the entire lining to get the infection out before closing the channel with stitches. In an advancement rectal flap, the surgeon will first close the internal opening of the fistula and then cover it with a flap taken from the rectal wall. If the treatment suggested to you is a seton placement, then the surgeon will use a string made of latex or silk to drain out the infection. If a fibrin glue or collagen plug is being used, then the internal opening of the fistula will first be closed before the glue or plug is injected into the fistula to close the tunnel. If a LIFT procedure is being used, there are two steps to expect. The first is that the surgeon will start with a seton procedure to widen the fistula over a period of time. Then the fistula will be closed.
If you have developed an anal fistula, then you are eligible to seek out treatment for it.
If you are allergic to silk or latex, a seton placement and a LIFT procedure may be out of the question for you. Furthermore, if you do not have an anal fistula, then you cannot seek treatment for it.
Since all the procedures to treat anal fistulas are surgical, there are a few common side effects to expect. With most surgeries, bruising, swelling and pain is common. Anal incontinence is also one of the side effects of getting surgery in the anus or rectal walls. Constipation, an inability to walk, and disorientation due to pain are also some side effects that one can experience. Some people end up being allergic or latex or silk and therefore can develop complications if they have opted for a seton placement or a LIFT.
One of the major post treatment guidelines is a strict control over the diet as it is imperative that the digestive tract functions normally in the days after surgery. This is because the aim is to allow the anus and rectal walls to heal in their natural state, otherwise it can cause problems with excretion later on. As a result, the patient will have to maintain a diet that is high in fibre and stay away from spicy food for a while. For often than not, if everything is going smoothly, patients are discharged after their first successful bowel movements and are allowed to recover in the comfort of their homes.
Patients are normally discharged after having their first bowel movement, which normally occurs within one or two days. However, it takes close to two weeks to recover fully from the surgery and its effects. The internal stitches within the body also dissolve around this time.
The surgical procedure can cost anywhere between Rs 98,000 – Rs. 3,00,000, depending on the hospital and city that you get the procedure done from.
The results of the treatment are permanent.
There are no home remedies or alternatives to the treatment. It is important to get the fistula corrected as soon as possible as further infections can lead to complications.