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What is a Fistula?
A fistula is a condition where an abnormal passageway forms between two parts of the body that are not meant to be connected otherwise. One of the most common types of fistula is the anal fistula. An anal fistula refers to the condition where a connection forms between the anus and the skin near it.
There are glands inside the anus which secrete fluids and they might get clogged due to some reason. This leads to the buildup of the secretion and the growth of bacteria, resulting in a pocket of swollen infected tissue. An anal fistula is usually the result of this infected tissue making its way by breaking out into the skin. The fistula is the tunnel created by the infected fluid connecting the gland to the skin.
An anal fistula is painful and causes pain during bowel movements. The anal fistula requires immediate medical attention. The best way to treat this ailment is anal fistula surgery.
Types of Fistula
Intersphincteric fistula
The tract begins in the space between the internal and external sphincter muscles and opens up very close to the anal opening.
Transphincteric fistula
In this, the tract begins in the space between the internal and external sphincter muscles or in the space behind the anus which crosses the external sphincter and opens an inch or two outside the anal opening. These can wrap around the body in a U shape, with external openings on both sides of the anus (called a horseshoe fistula).
Suprasphincteric fistula
The tract begins in the space between the internal and external sphincter muscles and turns upward to a point above the puborectal muscle, crosses this muscle, then extends downward between the puborectal and levator ani muscle and opens an inch or two outside the anus.
Extrasphincteric fistula
The tract begins at the rectum or sigmoid colon and extends downward, passes through the levator ani muscle and opens around the anus. These fistulas are usually caused by an appendiceal abscess, diverticular abscess or Crohn's disease.
Causes
Crohn’s Disease
This is an autoimmune disease that majorly affects the small intestine and causes bowel disorders. This disease can lead to the development of the anal fistula.
Diverticulitis
This is a disease where small pouches develop in the digestive tract (especially the large intestine), causing inflammation. An anal fistula is one of the effects of this ailment.
Trauma
Trauma refers to any kind of injury to the anus that can cause the development of the fistula. Trauma during intrusive anal surgeries can be a cause of anal fistula.
Radiation
Fistula in the anus can develop as an effect of radiation therapy for rectal cancer (the radiation is done on the anus).
Chronic Diarrhoea
Chronic diarrhoea can disrupt the functioning of the anus and lead to a fistula.
Symptoms
Foul smell from the anal region
The fistula causes a passage to form between the anal glands and the skin which appears as a tiny hole externally. This is accompanied by a foul-smelling discharge from the anal canal.
Pain in the anus region
An anal fistula causes pain around the anus region along with discomfort.
Swelling in the anal region
The anus gets swollen due to the infection.
Painful movement of bowels
Anal fistula disrupts the movement of bowels and causes pain in doing so too.
Bleeding
Bleeding while bowel movements can be caused due to a fistula.
Fevers
A general feeling of fatigue and feeling feverish is a strong indicator if it is accompanied by other symptoms of fistula.
Prevention
Intake plenty of fluids
Consume a fibre-rich diet regularly
Make sure that the anal region is not kept moist
Avoid straining while stool passing
Exercise regularly
Anal Fistula Diagnosis and Treatment Options
Laser fistula surgery
This is a painless procedure where the fistula is shut with the help of a laser. A laser beam is used to destroy the abnormal lining of the fistula and complete the removal of any infection in that region. This promotes healing in the region of the fistula. This surgery is very effective in a majority of anal fistula cases.
Fistulotomy
Fistulotomy is the most common surgical method for the treatment of anal fistula. This procedure helps the fistula heal from the inside out by opening it up and removing the entire lining of the tunnel(anal fistula) along with the infected tissues. It heals like a scar. This surgery takes very little time and is a very effective option for fistula treatment.
Seton Placement
This anal fistula surgery is suggested by a doctor when the fistula may require a drainage channel post-surgery. A drainage tube is placed to drain any fluids that may build up after the anal fistula surgery. Once the fluid drainage stops, the seton (drainage tube) is removed and the area is allowed to heal completely.
Advancement Flap Procedure
The surgery is performed when the fistula passes through the anal sphincter muscle. The fistula is removed during surgery and the area is replaced with tissues taken from another part of the anus to promote healing.
LIFT Procedure
Ligation of the intersphincteric fistula tract (LIFT) is an option only when a fistulotomy is risky for the patient. The fistula is sealed at both ends in the surgery.
Endoscopic Ablation
This anal fistula surgery seals the fistula with the help of electrodes passed through a device inserted through the anus. This process is very effective and requires no incisions.
Fibrin Glue
The fistula is sealed shut with the help of surgical glue to control its growth.
Bioprosthetic Plug
An external plug is applied to the anal fistula, which blocks the internal opening. This treatment method is simple and effective.
** All content is written and reviewed by medical experts
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Frequently asked questions
How long does it take for a fistulotomy to be completed?
The fistula operation is simple and gets completed within 30 minutes.
Is Laser treatment for fistula cost very high in India?
No. The fistula laser treatment cost is very reasonable when you book your Surgery through PharmEasy where you can save up to 20% on your total bill.
How much Does Fistula Operation Cost in , India?
If you are suffering from a fistula abscess, then opting for fistula surgery is the safest and quickest remedy. Approximately, anal fistula surgery costs is starting from INR 35,000 only. However, the cost depends on a number of factors. To know how much fistula surgery will cost you exactly, contact the PharmEasy support team. PharmEasy SurgiCare offers you a minimum of 20% savings on 100% cashless procedure and also the benefit of Costless EMI. For all the Insurance holders, the surgery cost will be zero.
Does PharmEasy provide insurance coverage for fistula surgery ?
PharmEasy SurgCare is not an insurance company or regulatory body. The extent of your health insurance coverage completely depends on the type of health insurance plan purchased and the terms and conditions put forth by the company. The PharmEasy team provides you with complimentary insurance documentation and processing and the option of zero-deposit admission if you are already insured.
What are the chances of recurrence of fistula after surgery?
There is a minimal chance of the recurrence of fistula after surgery. Follow the instructions and medications advised by your doctor after surgery to reduce the risk of any recurrence.
How long does it take for a fistula to heal?
The recovery time for anal fistula differs from patient to patient based on the severity of their condition. There are factors like comorbid conditions, age, type of fistula that affect the recovery time. Generally, it takes around 1 week to heal from the surgery but the recovery time may extend to 4 or 6 weeks.
How long does it take for a fistulotomy procedure to complete?
The surgical procedure is simple and gets completed within 30 minutes.
Will I bleed after a fistulotomy?
No, there is no bleeding in the laser fistula surgery procedure
Is laser fistula surgery painful?
No, Laser fistula surgery is a painless procedure that does not even involve any incision.
Will there be a loss of continence?
There is no loss of continence during a fistulotomy since this fistula surgery method specifically avoids that.
Can I drink alcohol after fistula surgery?
No, you should avoid drinking alcohol after fistula surgery as it can cause dehydration and worsen your condition which means the affected area will take longer to heal.
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Why Fistula Surgery?
- A procedure with minimal pain.
- Advanced technology is used for accurate and quick surgeries.
- Minimal to no bleeding after a procedure.
- The recurrence rate after surgery is minimal.
- Surgery is done by doctors with over 7 years of surgical experience.
- Cuts and stitches are avoided to the maximum possible extent.
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