Anal fistula is one of a common problem among the geriatric people and also most of the elders will neglect the problem due to Pain and other associated illness. We can help our elders only if we know about the problem completely. Let us take a snap shot to know about anal fistula. Anal fistula is defined as a small excavate like structure that is found near the anal region. It is formed due to infection in the anus region and collection of pus happens. When the abscess drains off it will lead to excavation called as fistula.
The signs and symptoms of anal fistula include
- Irritation of skin around the anus
- Excruciating pain which worsens while sitting, moving around, coughing and having bowel movement
- Foul odor in the discharge from the anus
- Bleeding or pus discharge while passing feces
- Swelling and inflammation around the anus
- High temperature if abscess present
- Bowel movement will be difficult to control in few instances
Most of the anal fistulas develop after the formation of anal abscess in which the pus have not drained properly and the other causes are,
- Crohn’s disease– a disease of the digestive system which is characterized by inflammation that is present for long time.
- Diverticulitis – a condition that infects the large intestine – colon part. Here the inside layer of the intestine develops small pocket like structures which becomes infected
- When a person suffers from chronic disease like tuberculosis or HIV.
- Hidradentitissuppurativa – a long term skin infection that causes blister or disfigurement.
- Previous surgery in the anus.
Anal fistulas are usually treated with surgery because they do not heal if left untreated. The aim of the surgery is to repair the fistula without causing injury to the sphincter muscles because if harmed it will lead to uncontrolled bowel movements.
- Fistulotomy:This is the commonly used procedure for treating anal fistula. The fistula is cut along its length so that it heals as a flat scar. This procedure is suitable only for fistulas that are not formed around the sphincter muscles.
- Advancement flap procedure:When the anal fistula passes through the sphincter muscles then this technique is used as it avoids bowel incontinence. The fistula is cut or scraped down and the hole is covered by the tissue taken inside the rectum.
- LIFT procedure:The ligation of intersphincteric fistula tract is a latest technique that is used to treat anal fistulas which pass through the sphincter muscles. An incision is made in the skin above the fistula and then the sphincter muscles are spaced out and the fistula is covered at the ends.
- Fibrin glue:This is the only non-surgical technique that is used to treat anal fistulas. You will be given general anesthesia and then the surgeon will inject the glue in the fistulas and it becomes sealed. This procedure is less effective and is useful for the fistulas that pass through the sphincter muscles.