The anus is the external opening through which the fecal matter is expelled from the body. There are many small glands inside the anus. If any of these glands becomes blocked, an infected cavity called an abscess may form. Over 50% of these infected cavities may form into a fistula. A fistula is nothing but a small channel that connects infected gland to a skin opening around the anus.
Causes for Anal fistula
An Anal abscess is the prime cause of fistula formation. However, fistulas may also be caused by STD, TB, Crohn’s disease, Diverticulitis.
Symptoms of the Anal fistula
- Swelling and pain around the anus
- Recurrent abscess in or around the anus
- Bleeding
- Skin irritation around the anus due to continual drainage
- Chills, fever and a feeling of fatigue
Anal Fistula diagnosis
Magnetic resonance imaging (MRI) helps in visualizing the anal fistula details, especially for recurring and complex cases.
Sigmoidoscopy helps to view the sigmoid colon and rectum. This test is quite useful to the patients who suspect to have ulcerative colitis, Crohn’s disease.
Anoscopy is done to view inside the anus, including the internal opening of the fistula if present
Anoscopy is done to view inside the anus, including the internal opening of the fistula if present
Anal Fistula treatment
Minimally Invasive Anal Fistula treatment (MAFT surgery) is ideal for High or Complex anal fistulas. The procedure is done through the external opening of the fistula. Through the external opening, a fistuloscope is inserted to view the fistula tract and localize the internal opening. An irrigation solution is used to view the fistula tract clearly. This inflation helps in localizing the internal opening of the fistula tract by advancing the fistuloscope through the track gently. Soon after locating the internal opening, it is sutured. Then the surgeon examines for the entire track for any secondary fistula or abscess cavity.
If the abscess cavity and secondary fistula are found, they are drained and with the help of a monopolar electrode, a fulguration is performed. With the help of endobrush that is passed through the fistuloscope, the damaged tissue is removed. Finally, the internal opening is disconnected by stapler firing. A temporary dressing is done at the external opening. The Patient is usually discharged the next day.
Dr. Nikhil Agnihotri is an expert in providing anal fistula treatment in New Delhi with an advanced surgical procedure. The advantages of Minimally invasive technique (sigmoidoscopy in India) are
- No large wounds or dressings
- No incontinence even in complex fistulas
- Early return to work
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