Food Habits: What To Eat And What To Avoid In Anal Fistula

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Introduction

The anus is the external opening of our digestive system located at the lower bottom of the rectum, through which our stools are excreted from the body. Inside the lining of the anus, there are small glands that create the mucus. Sometimes, due to various sets of reasons like injury or abrasion, these glands can get clogged and infected over time, causing an abscess. An abscess is an infected cavity in the anus. Most of the time, half of the abscess creation can lead to the formation of a fistula.

An anal fistula is a small tunnel that connects this abscess to the opening of the skin around the anus. This tunnel is an abnormality, connecting two linings or spaces that are normally not connected in nature. The abnormal connection happens between the epithelialized surface of the anal canal and the perianal skin. Although the most common location for a fistula is around the anus, it can rarely develop anywhere between the vagina and the rectum or an intestine and the skin. Anal fistula requires immediate diagnosis, treatment or surgery. However, your doctor may recommend certain foods to consume or avoid to help you deal or cope with the pain and discomfort.

10 Best Food for People with Fistula

Patients suffering from fistula should drink plenty of water and add food items rich in fibre to their daily diet. Make some changes in their food habit and in addition, they can inculcate the following:

1. Cereals 

Cereals include a wide array of food items like broken wheat, quinoa, brown rice, ragi and oatmeal. Cereals are loaded with fibre content. Fibre is essential for the optimum functioning of the body. It aids in good digestion and ease while passing stools, thus reducing strain and pain. 

2. Pulses

Kidney beans, moong dal, chickpeas, masoor dal and soybeans are important pulses. Pulses provide protein and are high in fibre, thus helping to keep the digestive tract clear. Pulses keep you full for a long time and while excreting, they add bulk to the stool because of having high fibre content. Without strain, you can have a smooth bowel experience and have less pain. 

3. Green Leafy Vegetables

Green leafy veggies like kale, lettuce, microgreens, cabbage, spinach and bok choy, should be included in your everyday diet. Besides having ample vitamins, minerals and a hoard of other nutrients, green vegetables are a high source of fibre. Besides keeping you fuller for a long time, they digest easily and help you excrete with ease.

4. Fresh Fruits

Fruits like apples, avocados, bananas and pears are high in fibre content. High-fibre fruits lower the chances of flare-ups, pain and inflammation that come with anal fistula. Include a variety of fruits in your daily diet. A quick fruit salad is not only healthy but has tons of fibre and will keep you fuller.

If you’re looking for food recommendations while dealing with anal fistulas, I suggest enjoying some raspberries. Just around 10 raspberries, amounting to roughly 19g, contain approximately 1.24g of fibre. The high fibre content may help promote regular bowel movements and soften the stool allowing the fissure to heal.

Dr. Rajeev Singh, BAMS

5. Brown Rice

 If you have seen brown rice, you will notice that its outer layer is unpolished. Brown rice is full of dietary fibre and has a positive effect on lowering the chances of constipation. It targets the anal fistula by making bowel movements smoother and is highly beneficial for patients suffering from anal fistula. 

6. Coconuts

Coconuts are high in fibre content, which helps bulk up your stool and supports bowel regularity. On the other hand, Coconut meat contains large amounts of medium-chain fatty acids (MCFAs), a type of saturated fat that is much easier for the human body to digest than animal fats, keeping your digestive system healthy. 

7. Some Milk Products

Skimmed milk and yoghurt are beneficial for people suffering from anal fistula. Consuming yoghurt may be helpful if you have irritable bowel, as yoghurt contains ‘probiotics’ or good bacteria, that help put healthy bacteria back into your gut system. This can help to prompt better digestion and thus help with a smooth bowel with less pain or irritation.

8. Fish

Certain kinds of fish, especially sea fishes like salmon, mackerel and tuna are an excellent source of omega-3 fatty acids, such as EPA and DOHA. Omega 3 helps maintain a good and healthy body. These fatty acids can play a vital role in healthy bowel function. They can work to lubricate the digestive tract and keep faeces flowing smoothly.

I recommend incorporating high-fibre foods into your diet, such as chia seeds, which contain 3.4g of fibre per 10g. This may be very helpful for individuals dealing with anal fistula.

Dr. Siddharth Gupta, B.A.M.S, M.D (Ayu)

Foods to Avoid for Fistula

Indigestion, constipation, bloating or diarrhoea may trigger symptoms or cause dire effects related to anal fistula. Hence, food items that may cause the above situations must be strictly avoided by patients suffering from anal fistula. Here are some foods to avoid:

1. High-fat Dairy Products

Double-fat milk, cheese and other heavy milk and cream products should be avoided as they are harder to digest and can cause stomach ailments.

2. Fast Food

Fast foods are no doubt delicious and mouth-watering to taste. Street vendors selling all kinds of lip-smacking dishes should be avoided by fistula patients. Fast food consumption should be toned down, along with consumption of food items made with purpose flour (maida) should be curbed until symptoms have lessened.

3. Spicy Foods with Chilly Powder

 Indian dishes often consist of spicy pastes and curries that are quite difficult to digest. Try consuming simple homemade food that can be made accordingly. Anything that aggravates the stomach will not be a great option to try while suffering from an anal fistula.

4. Fried Foods

Negligible nutrition content, hard to digest and not healthy, fried food should strictly be avoided if you have an anal fistula.

5. Salty Foods

Bloating can make excretion tedious. Consuming too salty food items will not only make you feel bloated but may also aggravate your stomach and cause irritable bowel syndrome.

6. Red Meat

There is nothing new in the fact that red meat is quite hard to digest. Having very little fibre, the stomach takes a lot of effort to digest it and it does not even add bulk to the stool. Thus, too much red meat cooked in oil and spices should be kept at bay.

7. Alcohol

Dehydration can make stool passing difficult Alcohol heavily contributes to dehydration in the body. A heavy amount of alcoholic beverages can pose a problem for people with fistula.

8. Caffeinated Beverages

Strong coffee like black coffee or heavy milk tea is no doubt exquisite, but should be avoided as long as your symptoms are not gone.

9. Packaged Foods

Pre-packed foods like chips, fries and frozen food items should not be consumed in moderation or avoided. They barely have any nutritional content that gets lost in the freezing process. 

Fistula-Friendly Recipes to Try

Simple homemade dishes like daliya, poha, upma, dosa, khichri, steamed/grilled chicken, boiled vegetables or chicken stew can be consumed by people with fistula. Some of the recipes you can try are as follows:

1. Lentil Tomato Salad

• Add chopped cherry tomatoes, chopped cucumber and boiled lentils to a large mixing bowl.
• Add lemon juice, chaat masala and ground black pepper.
• Mix well and enjoy this immensely simple and healthy salad.

2. Chicken and Chickpea Salad

• Take two chicken breasts and boil them.
• Once cooled down, shred the chicken. You can also use leftover chicken for this recipe.
• Add boiled chickpeas, boiled corn and some shredded cheese.
• Mix them well and add ground black pepper and any light bonding sauce.
• Enjoy this high protein and fibre salad alone or with some brown bread.

I advise adding nuts to your diet to potentially help with anal fistula discomfort. Nuts are a great source of fibre. They may provide around 6 to 8 grams of fibre per serving, which might aid in promoting easy bowel movements and less pressure on the anal area.

Dr. Smita Barode, B.A.M.S, M.S.

3. Bell Pepper, Carrot and Hummus Sandwich

• Take two slices of whole wheat or multigrain bread and lightly toast them.
• Slice bell peppers, finely sliced carrots, cucumbers and tomatoes. Set aside.
• Take chickpeas and bring them to a boil.
• Add the boiled chickpeas, lime juice, salt, black pepper and coriander to a mixer grinder. Mix them to make a smooth paste.
• Lather this paste (hummus) onto each slice of bread.
• Add the chopped vegetables to one slice. 
• You can also add sliced boiled eggs to enhance the taste of the sandwich.
• Put the other slice on the loaded one.
• Enjoy the sandwiches as a healthy evening snack.

Thus, well-cooked food at home loaded with fibre is a good option when suffering from fistula. These are, however, only suggestions. It is best to stick to your doctor’s advice on what to eat and what to avoid based on your overall health and food choices. If you are a vegan, your doctor will provide you with vegan recipes and the like. Depending on the severity of your condition along with medications and other treatments, a good diet will help ease the recovery process. 

Frequently Asked Questions (FAQs):

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