Anal fistula is the appearance of a small channel between the tip of the intestine and the skin around the anus. This condition can be triggered by various types of diseases, such as tuberculosis, Crohn’s disease, cancer, sexually transmitted diseases, or have had surgery in the anal area. Pain in the anus and mucus or blood during bowel movements are some of the symptoms of anal fistula.
Anal fistula is formed from an abscess in one of the small glands in the anal canal. Anal abscesses develop when the small glands in the anal canal become blocked and then an infection occurs. Anal fistula is shaped like a tube that resembles a tube and its length starts from the anal canal (rectum), to the hole in the skin around the anus.
Beware if you experience the following things. This could be a symptom of anal fistula:
- The skin around the anus appears red, itchy and painful.
- Continuous and very annoying pain when sitting, moving, coughing or defecating.
- There is pus around the anus
- Fever and weakness.
- Pus or blood during bowel movements.
Main Causes of Ani Fistula
In general, anal fistulas are caused by an infection of the anal gland that causes pus buildup. The anal fistula then forms a channel under the surface of the skin that is connected to the infected gland. If it cannot dry on its own, the pus must be removed by surgery.
In general there are two main causes of anal fistulas, namely:
Inflammation of the intestine
- Diverticulitis or infection in a small bag on the side of the large intestine.
- Crohn’s disease is a chronic condition that causes inflammation of the walls of the digestive tract.
This condition is generally accompanied by abscess or accumulation of pus in the anus. Pus usually appears after the small glands in the anus are infected with bacteria. This condition often occurs in people with low endurance, such as people with HIV or those who have undergone chemotherapy or radiation therapy to treat colon cancer.
Anal fistulas can also be caused by complications and disorders of the large intestine caused by the following conditions:
Anal fistulas can also be caused by other conditions, such as:
- Anal and colon cancer.
- Wounds around the anus or anal fissure.
- Tuberculosis due to bacteria that infect the lungs can spread to other parts of the body including the digestive tract.
- Sexually transmitted diseases, such as chlamydia.
- Complications due to surgery.
Overcoming Ani Fistula
After consulting a general practitioner, you may be referred to a digestive surgeon for further examination. The specialist doctor will perform physical examination on the anus and proctoscopic examination, which is an examination tool made specifically to look inside the anus. If a fistula is suspected, the doctor will recommend an ultrasound, MRI, or CT scan.
Management of anal fistulas is generally done by surgery, and the type of surgery depends on the position of the fistula. Here are some of the types of surgery commonly done to treat anal fistulas:
- Fistulotomy. The procedure, which is applied in about 90% of cases of anal fistula, is performed by opening the entire fistula to remove its contents.
- Seton technique. A seton is a thread placed in the fistula duct. This technique is done if the patient is at high risk of incontinence. This condition can occur when the fistula crosses the sphincter muscle or a collection of muscles at the tip of the anus.
- Advance flap procedure. An advancement flap is a part of tissue that is removed from the anus or the skin around the anus. This procedure is carried out in cases of anal fistulas that are classified as complicated.
- Bioprostetic Plugs. Namely a cone-shaped stopper made from human body tissue. This blockage is used to partially close the duct in the fistula.
After surgery, treatment with antibiotics is also needed to prevent recurrent infections. Generally, healing takes approximately 6 weeks. In the first weeks, the scar may bleed and ooze, so it’s best to use a bandage or a small towel on your underpants to hold the body fluids.
In addition, the doctor may prescribe painkillers to reduce postoperative pain and laxatives to help defecate.
The risk of complications arising after anal fistula surgery varies depending on the type of procedure performed. There is also a risk of complications that may occur are infection, intestinal incontinence, ani fistula conditions occur again.
But check yourself immediately if after surgery you experience complications such as high fever, nausea, infection, difficulty urinating, pain and swelling, and constipation.