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Anal Fistula Health Feed

Fistula - Know Forms Of It!

Fistula - Know Forms Of It!

fistula is an abnormal connection between two hollow spaces (epithelial surfaces), such as blood vessels, intestines, or other hollow organs. Fistulas are usually caused by injuries or surgeries resulting in infection or inflammation. Also sometimes fistulae are created for therapeutic purpose.

Types of fistulas include:

  1. Blind - with only one open end. Also known as sinus tracts
  2. Complete - with both external and internal openings
  3. Incomplete - a fistula with an external skin opening, which does not connect to any internal organ


  1. Eye, adnexa, ear, and mastoid process: Lacrimal fistula, carotid cavernous fistula, mastoid fistula, craniosinus fistula, labyrinthine fistula, perilymph fistula, and preauricular fistula
  2. Circulatory system: Coronary arteriovenous fistula, arteriovenous fistula of pulmonary vessels, pulmonary arteriovenous fistula, cerebral arteriovenous fistula, arteriovenous fistula, and fistula of the artery
  3. Respiratory system: Pyothorax with fistula and tracheoesophageal fistula
  4. Digestive system: Duodeno biliary fistula, salivary gland fistula, fistula of stomach and duodenum,  gastrocolic fistula, gastrojejunocolic fistula, enterocutaneous fistula, gastric fistula, fistula of appendix, anal and rectal fissures and fistulas, anal fistula, anorectal fistula, fistula of intestine, enteroentral fistula, fistula of gallbladder, biliary fistula, and pancreatic fistula
  5. Musculoskeletal system and connective tissue: Fistula of joint
  6. Urogenital system: Vesicointestinal fistula, urethral fistula, vesicovaginal fistula, cervical fistula, enterovaginal fistula, and rectovaginal
  7. Congenital malformations, deformations and chromosomal abnormalities: Congenital preauricular fistula, Portal vein-hepatic artery fistula, congenital fistula of lip, Congenital fistula of salivary gland, congenital absence, atresia and stenosis of the rectum with fistula, congenital fistula of rectum and anus, congenital fistulae between uterus and digestive tract, and congenital rectovaginal fistula


  1. Inflammatory bowel disease causes of anorectal, enteroenteral, and enterocutaneous fistulas.
  2. Complications from gallbladder surgery can lead to biliary fistula.
  3. Radiation therapy, obstructed labor can lead to vesicovaginal and rectovaginal fistulas. Also, vesicovaginal and rectovaginal fistulas may also be caused by rape with foreign objects.
  4. Obstetric fistula develops when the blood supply to the tissues of the vagina, bladder (and/or rectum) is cut off during prolonged obstructed labor.
  5. Head trauma can lead to perilymph fistulas.
  6. Trauma to other parts of the body can cause arteriovenous fistulas.
  7. External causes include traumatic arteriovenous fistula and persistent postoperative fistula.

Physical examination: to determine the extent and pathway of the fistula


  1. Treatment for fistula depends on the cause and extent of the fistula.
  2. Surgery is often required to assure adequate drainage of the fistula. The surgical intervention combined with antibiotic therapy is usually required
  3. In some cases, fistula is temporarily covered e.g. cleft palate fistula is treated with a palatal obturator to delay the need for surgery to a more appropriate age.
  4. Surgical procedures commonly used are fistulotomy, placement of a seton (a cord that is passed through the path of the fistula to keep it open for draining)
  5. Filling the fistula with fibrin glue
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A Detailed Study About Anal Fistula's Facts!

A Detailed Study About Anal Fistula's Facts!

An Anal fistula (also known as fistula-in-ano) is a small tunnel that can develop between anal canal and the skin near the anus often resulting from an untreated or inadequately treated perianal abscess. No medicinal treatment shows complete cure of anal fistula except few conditions like tubercular fistula. Early surgery, short & straight fistula tract and anal fistula treatment with ksharasutra give promising results with high rate of success.

Fast facts on Anal fistula

  • Essentially surgical intervention required.

  • Recurrence is common.

  • Should be planned for surgery as early as possible, late cases are mostly complicated.

  • Anal fistula treatment with ksharasutra shows high rate of success.

What Causes Anal fistula?

  • Abscess in buttock and/or around the anus.

  • Long standing anal fissure.

  • Traumatic injury to the perianal region.

  • Tuberculosis.

  • Crohn’s disease.

  • AIDS.

  • Not maintaining local hygiene.

What are the symptoms of Anal fistula?

  • Discharging wound at perianal region or buttock which is repeatedly swelling, discharging some amount of pus and/or blood and resolving. The swelling is often associated with pain and fever.

  • There may be single or multiple wounds.

  • Passing of flatus through the tunnel like wound.

What are the must know facts about Anal fistula?

  • Anal fistula is notoriously famous for its recurrence even after repeated surgery.

  • An anal sphincter-sparing or minimal invasive surgery should always be the choice of patient as well as surgeon.

  • Different surgical modalities are available for treatment of Anal fistula like fistulectomy, fistulotomy, video assisted anal fistula treatment, fistula treatment with laser, fistula plug, two-stage seton fistulotomy and multistage anal fistula treatment with ksharasutra, etc.

  • Anal fistula treatment with ksharasutra (Ayurvedic) has shown the promising result with the lowest rate of reported recurrence and complications like incontinence of stool.

  • Medicinal treatment is not considered as curative management except in few conditions like tuberculous fistula. 

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Laser Treatment For Fistula: An Analysis!

Laser Treatment For Fistula: An Analysis!

Hi, there. Let’s say you are driving to your office, trying to mentally recall all the things that you have already done in the day and the tasks you are supposed to accomplish. During the mind mapping, you realise that you haven’t gone to the bathroom. Big deal. You can take time to go later, right? I mean, it isn’t like your workplace doesn’t have a toilet. So, you are done with your day and heading back home, thinking of dinner, already. Hold on, there’s been a no show from your poop. It’s okay, you can go later.

 It’s been a couple of days now that you haven’t gone to the toilet properly, and as you drive through your usual route to your office, you wonder if you might have a problem in your rear end. Just then, your eye, coincidentally, notices an ad on the road. It’s about laser treatment. Dismissing it as one of those ‘get silky smooth skin’ ads that you don’t care about, you drive on. Even though the ad is gone, your problems with the rear end haven’t. There’s pain, there’s swelling around your anal region and worse still, there is some sort of very foul-smelling fluid oozing out. Oh dear. These are the hallmarks of a pretty nasty problem that’s building down there. You are embarrassed to even talk to anybody about this.

What would they think?

That you are someone with very poor anal hygiene, that you are dirty. You surely don’t want that! So, you do what most people with a smartphone do. You Google. Even before you can figure out what’s happening, the same laser ad is served to you on your screen. You scroll past, trying to understand what could have gone wrong with you. It looks like you have a fistula. Oh no! But then, instead of going to a doctor, you walk into a pharmacy and ask for medicines that Dr Google prescribes. Done deal, you consider, but hey, that might not be the case, actually. As your problem worsens and your whole routine starts falling out of place, you contemplate going to a doctor, but the thought of all those machines popping in and out of your sensitive parts traumatises you. What happens if those treatments render you the slave of an adult diaper? So, you Google again. The same ad appears. “What the hell,” you think to yourself, finally succumbing into clicking it. “Laser treatment for fistula. Painless and quick” Oh, there’s a ray of hope. A painless treatment would be great, right?

Bursting The Bubble Let’s first get down to the finer details. 

The ads that you are shown on your smartphone are curated especially for you. The keywords that you use in your search along with how many times you have used them in the past will determine what ads you see. That said, nobody is denying the effectiveness of laser as a medical tool. It’s a marvellous medical development that’s soon emerging as a doctor’s favourite. But, before you opt for this aggressively advertised treatment type, you need to know several things that are veiled from you and many others.

The Important Factors Before you go for a treatment for fistula, it’s best to first consult with an experienced coloproctologist, because hey, they are the people who know this stuff best. You can’t just walk into a hospital or clinic and say, “I’d like to order one laser treatment for fistula, please.”

It’s a different ballgame here. Your doctor needs to examine you and understand the following things.

  1. Is it really a fistula, or some other problem?
  2. In case it is a fistula, what grade is it in? For the unsuspecting, fistula is a nuisance that also has grades, from one to three, one being the least problematic. Grade one and two can be treated with medications and lifestyle changes, but if you have transitioned to Grade 3, then you need surgical treatment. Doppler Guided HAL RAR. In medical terms, this is a Hemorrhoid Artery Ligation with Recto Anal Repair and this is what a good doctor would recommend. This, in combination with the much-advertised Laser is what is needed to tackle this grade of fistulas.
  3. Next, of course, is to check what type of fistula you have. Oh yes, apart from Grades, these also come in types - Simple and Complex.
    • Simple Fistula: These can be treated using a technique called Simple Fistulotomy, in which laser is used to open the tract and drain the fluid out. Considering the precise nature of lasers, the cuts are neat, accurate and fast.
    • Complex Fistula: In this case, laser isn’t enough. Considering that the level of challenges are higher, your coloproctologist’s aim will be to save your sphincter muscles - the ones that control the passing of stool. In a botched up surgery, the risk of damage to these muscles is higher, leading to stool incontinence. Therefore, conventional fistula surgery, assisted by laser technology is what should be used.

A Dose Of Reality

The reason behind going into so many details is the fact that as a patient, you deserve to know the truth before you make any healthcare decision. The fact of the matter is - laser treatments alone are not effective for complex and high-grade fistulas. They are great as a tool for a surgery, but they can’t be termed as a treatment in themselves, especially when it comes to fistulas, because their clinical outcomes are not very pleasing. Even though they are very precise and cause minimal tissue burning, in turn minimising blood loss and helping quick recovery, they need to be combined with other procedure to be effective.

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Hi Sir, I am a 18 years old guy and I had surgery for a perianal fistula on the 1st of July. The doctors basically cut an open passage between the anus and the fistula which completely regenerated at the end of august. It's October now and I'm not sure if I can have anal sex with my boyfriend yet.

Anal fistula is a chronic abnormal communication between the epithelialised surface of the anal canal and usually the perianal skin. An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. Let's discuss your concern in detail so that we can provide you the best medical plan.
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मैं एक साल से फिस्टुला से परेशान हूं। fistulogram कराया तो 6 इंच टैक दिखा रहा है अगर क्षारसूत्र से इलाज कराये तो अधिकतम कितने महिने में 100% ठीक हुआ जा सकता है। मुझे डायबिटीज का नहीं है।

Hi lybrate-user. Actually it depends upon what type of surgery you r going to do. If only ksharsutra then it may take for 6 inches =15 cm tract. About more than 30 weeks. This can be reduced by using partial fistulectomy along with ksharsutra. But it is very difficult to evaluate the duration of treatment without examining the patient and taking other doctors opinion into consideration.
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My father is suffering from fistula in ano. Has undergone 1 sitting for ksharsutra. He is having pain there. And now, that doctor is advising for laser treatment. Please suggest your opinion and laser treatment best doctors in pune.

1. Take home cooked, fresh light food. Take a lot of green vegetables n fruit. 2. Increasing the fibre in your diet is known to be as effective as injections for preventing further problems 3. Increasing your fluid intake which can help prevent further problems with haemorrhoids 4. Avoiding straining and constipation which is the most useful thing patients can do to prevent the problem coming back. If the fibre content of your diet is not sufficient to keep your stools soft, then a fibre supplement can help. 5. Maintain active life style 6. Curd is good for u. 7. Avoid fast foods, spicy n fried foods Homeopathy has very encouraging results. Consult online with details
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In case of fistula how homeopathy works? Is first pus is completely drained by the path and then it will be healed? In my case after taking silicea 30 calc sulp and some other medicines, pus draining is increased? I am asking is this a good sign or not? I am using homeopath you medicines for last 15 days. Please suggest me.

Anal fistula can not be treated by oral medicines only - homeopathic/ allopathic or ayurvedic. So usually, surgery is advised in anal fistula patients. But surgery is not the right choice for the reason of the recurrence of fistula after surgery and other complications like stool incontinence (inability to hold stool) etc. However, this problem can be completely treated without surgery by graded ksharsutra treatment. No hospitalization or bed rest is required in this treatment. You can continue your normal routine activities as usual during this treatment. Clinical trials conducted by the indian council of medical research (icmr) at aiims - new delhi & pgi - chandigarh have confirmed that ksharsutra treatment is more convenient and more effective than surgery in patients suffering from anal fistula. For further support; you may call reception at sushruta ano rectal institute.
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I have fistula past a year now. I had taken Ayurveda medicine for 5 months from march to July. Some infection occurred in my stomach for which 2 pin holes appeared on my butt exactly where the fistula is, it was kind of a pin hole 1 month and a half back but now one of the hole has increased in size. I stopped the Ayurveda medicines in July as the doctor didn't bother to even check what has happened and just gave me medicines. She also fave some oil to insert into the anus. Since last a month I'm on homeopathic medicines. Can any Ayurveda medicine heal the holes. I don't want the 2 holes to join and become one very big hole. I need fast relief for this. I have no clue, now which doctor should I go to, as I do not want to get operated for it. And no one is giving proper reply for the infection. My stools are proper no constipation for last 7 months now. I'm on veg food too. Please help me.

Actually fistula is an abnormal connection between two hollow organs or between mucuos membrane & skin, so once it formed it becomes part of your body, moreover it can lead to complications like infections, abcess & off course neoplasia if not taken care of, I do not know how a medicine can resolve a already anatomical structure, suppose someone want to melt a part of the body which needs to be amputed for an accident or duabetic gangrene, now logically think & tell me, can you remove the gangrenous leg by medicine? Anyways its better if you consult a surgeon & resolve it as soon as posdible.
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मै पिछले 5 महिने से क्षारसूत्र से फिस्टुला का ईलाज कर रहा हुं 1 महिने पूर्व थ्रेड भी निकल चुका है लेकिन दर्द पस और खून निकलना पूरी तरह बंद नहीं हुआ। डाक्डर बहुत सारा आयुर्वेदिक 5 महीने से खिला रहा लेकिन कुछ लाभ नहीं हो रहा। मेरे मन मे अब डर बैठ गया कि पहले जैसे ठीक हो पाउंगा कि नही। किसी के पास सफल टेस्टेड ईलाज हो तो बताये।

क्षारसूत्र ट्रीटमेंट ही एक मात्र इलाज है जिससे फिस्टुला को पूरी तरह से ठीक किआ जा सकता है। क्षारसूत्र निकल जने के बाद भी pus और blood आना यह बताता है कि क्षारसूत्र से पुरे फिस्टुला ट्रैक को कवर नहीं किआ गया है। यही छूटा हुआ फिस्टुला ट्रैक दोबारा से activate हो रहा है। यदि फिस्टुला ट्रैक छूटा है तो इसमें दोबारा क्षारसूत्र ट्रीटमेंट करना होगा। इसमें सिर्फ खाने की दवाइयां कारगर नहीं होंगी। तो better होगा आप किसी experienced क्षारसूत्र विशेषज्ञ से कंसल्ट कर क्षारसूत्र ट्रीटमेंट करवाएं। sushruta ano rectal institute में consult करने और अधिक जानकारी के लिए आप रिसेप्शन पर कॉल करें।
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Hi, My mom is 50 years old. She has fistula from the last 15 years, but from the last two months, she is not able to sleep on her right side, because it hurts from hips to toe. Please help me.

Hi, My mom is 50 years old. She has fistula from the last 15 years, but from the last two months, she is not able to ...
fibrin glue is currently the non surgical treatment ,it help desk the fistula and encourage it to heal
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