What is an Anal Fistula?

The anal opening is surrounded on the inner side by mucous secreting glands that aid in the easy passing of stool. Sometimes, these glands may get infected and clogged and just like a pimple start filling up with secretions and pus quickly making it painful and swollen. This is called an abscess. About half of the abscesses that form in this region start draining out through a newly formed small canal to the outer side as pressure builds up inside. When this happens, it is called an anal fistula.

What are the Causes of Anal Fistula?

● Clogged anal glands causing abscesses
 ● Having Crohn’s disease - caused by inflammation in the intestine
 ● Having undergone radiotherapy
 ● Trauma
 ● Sexually transmitted diseases
 ● Tuberculosis
 ● Diverticulitis
 ● Cancer

What are the Signs and Symptoms of Anal Fistula?

● Recurring anal abscesses
 ● Pain and swelling in and around the anus
 ● Foul smelly bloody or pus-filled discharge from the opening of the fistula around the anal canal
 ● Irritation of the skin around the anus
 ● Difficulty and pain while passing stool
 ● Bleeding from the anal region
 ● Fever and chills
 ● General body weakness

How is Anal Fistula diagnosed?

If you have symptoms of an anal fistula, you should visit a gastro surgeon. The doctor will inspect the swollen area and try to see if it is draining pus. He may use different methods to help the diagnosis like:
● Fistula Probe - a long thin probe that helps in the injection of a dye to see where the
fistula opens on the inside of the anus
● Anoscope - a scope to see into the anal canal
 ● Imaging Studies - ultrasound or MRI to assess the tissue

How is Anal Fistula treated?

The best case would be to identify the problem in the abscess stage and try to correct it then before it develops into a fistula. Once you have a fistula, antibiotics alone can not cure it. Surgery becomes necessary for a cure. If you have Crohn’s disease as well, medical treatment is tried first. Some of the common procedures are:
 ● Fistulotomy - A single-visit procedure which opens up the fistula inside out so that it heals(done in small fistulas)
 ● Filling with special glue or plug - A newer treatment that closes the inner opening of the fistula. The filling is a substance that is absorbed by the body over time.
● Reconstructive surgery - Advanced cases may require reconstructive surgery done in multiple stages.
● Seton - Placing a suture or a rubber band called seton that slowly tightens and aids in healing while reducing incontinence.
 ● Laser ablation of fistula tract (FILAC)

How can you aid the recovery from Anal Fistula?

● Ensure you take the painkillers suggested by your doctor only
 ● Ensure you finish the full course of prescribed antibiotics
 ● Soak in warm water 3-4 times a day(sitz bath)
 ● Wearing a pad till fully healed
 ● High fibre diet
 ● Staying hydrated
 ● Stool softener as per the advice of your doctor