Fistula in Ano is an inflammatory track which has an external opening in the perianal skin and an internal opening in the anal canal or rectum. Usually, this track is lined by unhealthy granulation tissue and fibrous tissue.
Usually Anal Fistula generates from anal glands those are located between the anal sphincter. Anal Fistula also describe as a narrow tube with internal opening in the anal canal and external opening in the skin near of the anus.
If this external opening seals over, there is a chance of accumulation of pus near to this skin sealed area. Most of the time, Fistula can be occurred in your Adult life, and rarely see at Children and Infants too.
What are the Causes for Fistula?
Anal glands are located in the walls of Anal canal between the internal and external anal sphincter and these anal glands are supposed to drain into anal canal. The obstruction of these glands can cause plugging and this secondary infection or block on these outlets of anal glands will eventually leads to abscess formation near to the anal area.
These Perianal abscess comes in the inter-sphincter area of the anal and associated with infection in the anal gland. This abscess can eventually extend to the surface of the skin. This extended tract formed by this process is called Fistula.
As per Fistula Foundation, “Obstetric fistula most commonly occurs among women who live in low-resource countries, who give birth without access to medical help. If a woman’s labor becomes obstructed, she could remain in excruciating pain for days before her baby is finally dislodged. Her baby likely dies and she is often left with an obstetric fistula, a small hole created by constant pressure from the fetus, which renders her incontinent”.
There are some other disorders must be considered that may also cause Anal Fistula, those disorders are Ulcerative Colitis, Crohn’s Disease, Tuberculosis, Carcinoma of the rectum etc.
What are the Types of Fistula?
In general, based on the nature of the Fistula tract this Anal Fistula can be grouped into two, Low level fistula and High level fistula. The above classification is made based on whether the internal opening is below or above the anal rectal.
Based on the nature of the Fistula, it can be single or multiple. When there is more than one external opening, it is considered as Multiple Anal Fistula and this multiple Fistula may have more than one internal opening too.
Signs and Symptoms of Fistula
The main symptom of Fistula is the recurrent perianal abscess. The frequency of these abscess may be 1 week to couple of months. Once this abscess formed near to Anal area, it will have ruptured by itself after few days and this condition healed by leaving a tiny discharging sinus.
There are other signs that may be noticed if you have already have Anal Fistula such as Skin Maceration, Discharge from Anas or external Fistula opening, Constant Pain near to Anal when sit down or have bowl movement, Swelling, Unusual Tenderness and Redness near to Anus area, Indurated area etc.
If you think you have Anal Fistula, please visit an experienced physician or colorectal specialist before proceeding with the treatment.
What are the treatment for Anal Fistula?
There are several stages and types to treat anal fistula based on the nature and type of Fistula and the ultimate aim of the treatment should be completely eradicating the Fistula tract from your body and their by stop its recurring. We will disuses further about the treatment in the next article.