Anal fistula: causes, diagnosis and treatment
Written by:An anal fistula is a communication (tunnel) between the skin surrounding the anus and the interior of the rectum. In some cases the anal fistula occurs as a manifestation of other pathologies, such as Crohn's disease.
Causes of an anal fistula
The origin of the anal fistula is usually an abscess that has drained to the skin, causing a communication between the anal fistula and the interior of the anus or rectum. Only in half of cases of drainage of an abscess will an anal fistula result.
How to diagnose an anal fistula
The anal fistula is manifested by the chronic discharge of pus or feces from the hole in the fistula located in the skin of the anus.
For the diagnosis of fistula, the most important criterion is the anal examination by a surgeon specialized in Coloproctology. Imaging tests such as anal ultrasound or a pelvic MRI may sometimes be needed.
Treatment for anal fistulas
Anal fistulas are classified as simple or complex , depending on the degree of anal sphincter involvement .
The treatment to be used is surgery , and the technique varies according to the type of fistula and according to the patient's history and local conditions (history of anal surgeries, inflammatory disease or other risk factors for the appearance of anal incontinence). In most cases, the fistula is simple and can be treated on an outpatient basis. Thus, the patient only remains for a few hours in a hospital. In these cases and, usually, you can return to work activities in a short period of time.
When the fistulas are complex the treatment of the fistula is more laborious and requires a great experience on the part of the specialist in Coloproctology to decide which of the present techniques is the most suitable for the patient and for his type of fistula. At present, there are treatments such as LIFT ( minimally invasive surgery of the anus ), stoppers , tails , lasers , clips and even, in very selected cases, the use of stem cells .
Not all options are ideal for all fistulas and for all patients. In order to minimize the risk of complications such as relapse, incontinence or others, it is of vital importance that the surgeon who evaluates and treats patients has a great experience in this pathology.
