Anal fistula or fistula-in-ano is an abnormal connection or channel like structure, between the surface of the anal canal and the exterior perianal skin.

Anal fistulae originate from the anal glands, which are located between the two layers of the anal sphincters and which drain into the anal canal. If the outlet of these glands becomes blocked, an abscess can form which can eventually point to the skin surface. The tract formed by this process is the fistula.

 

Causes Of Fistula

  • Anal fistulas commonly occur due to an anal abscess.
  • An abscess is a collection of pus and infected fluid.
  • An anal abscess usually develops after a small gland, just inside the anus, becomes infected with bacteria. A fistula may occur if an abscess has not completely healed or if the infected fluid has not been entirely drained away.

 

An anal fistula may also develop as a result of

  •  a growth or ulcer (painful sore)
  • a complication from surgery
  • a congenital abnormality (a health problem that you were born with) 

 

Anal fistulae are also a common complication of conditions that result in inflammation of the intestines. Some of these conditions include 

  • Irritable bowel syndrome (IBS): a chronic (long-term) disorder that affects the digestive system, causing abdominal pain, diarrhoea and constipation.
  • Diverticulitis: the formation of small pouches that stick out of the side of the large intestine (colon), which become infected and inflamed.
  • Ulcerative colitis: a chronic condition that causes the colon to become inflamed and can cause ulcers to form on the lining of the colon.
  • Crohn's disease: a chronic condition that causes inflammation of the lining of the digestive system.

 

Symptoms Of Fistula

Anal fistulae can present with many different symptoms such as:

  • Pain.
  • Discharge- either bloody or purulent.
  • Pruritus ani– itching around the anus.
  • Systemic symptoms if abscess becomes infected.

 

Diagnosis Of Fistula

Diagnos style is by examination, either in an outpatient setting or under anaesthesia. The examination can be an Anoscopy.

 

Possible findings

  • The opening of the fistula onto the skin may be seen
  • The area may be painful on examination
  • There may be redness
  • A discharge may be seen

It may be possible to explore the fistula using a fistula probe (a narrow instrument) and in this way it may be possible to find both openings of the fistula

 

Treatment 

Our treatment advises internal medication as well as topical ointment application in the treatment of Anal fistula. To avoid further irritation to the damaged tissue, medicines which soften the stools and promote healing of the tissues are utilized. Ointments which are natural anti-bacterial and anti-septic are used for topical application.