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GI and Laparoscopic

Fistula in Ano

Laparoscopic

Best treatment of Fistula in Ano in Hyderabad

Treatment for fistula in ano may involve surgical intervention to remove the infected tract and promote healing. Options include fistulotomy, seton placement, or more complex procedures like advancement flap or LIFT (ligation of the intersphincteric fistula tract).

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Dr Krishna Chaitanya
Dr. Krishna Chaitanya
MBBS, MS , FMAS
(Fellowship in Minimal Access Surgery)
GI and Laparoscopic Surgeon
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---- Overview ----

Fistula in Ano

A fistula in ano is an abnormal connection between the anal canal or rectum and the surrounding skin. It is often caused by an infection or an abscess in the anal area. Symptoms include persistent discharge, pain, swelling, and sometimes fever. Treatment typically involves surgery to remove the fistula tract and promote healing. Various techniques such as fistulotomy, seton placement, or advanced procedures like advancement flap or LIFT may be used depending on the complexity and location of the fistula. Regular follow-up is necessary to ensure proper healing.

what are the causes of Fistula in Ano?

Fistula in ano can have various causes, including:

  • Anal Abscess: An anal abscess is a localized infection that forms a collection of pus near the anus. If the abscess is not adequately treated or drained, it can lead to the formation of a fistula.
  • Inflammatory Bowel Disease (IBD): Conditions such as Crohn's disease and ulcerative colitis, which are types of IBD, can cause chronic inflammation in the digestive tract. This inflammation can lead to the development of fistulas.
  • Trauma: Injury or trauma to the anal area, such as from childbirth, anal surgery, or injury during sexual activity, can result in the formation of a fistula.
  • Cryptoglandular Infection: This is the most common cause of fistulas in ano. It occurs when the small glands in the anus become infected, leading to the development of an abscess and subsequent fistula formation.
  • Radiation Therapy: In some cases, radiation therapy used to treat certain cancers in the pelvic area can cause damage to the tissues, leading to the development of fistulas.

It's important to note that not all cases of fistula in ano have a clear identifiable cause, and sometimes the exact cause may remain unknown.

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what are the Symptoms of Fistula in Ano?

Symptoms of fistula in ano may vary depending on the location, complexity, and extent of the fistula. Common symptoms include:

  • Persistent or recurring pain around the anus or rectum.
  • Drainage of pus or fluid from an opening near the anus.
  • Itching or irritation around the anus.
  • Swelling or a lump near the anus.
  • Redness or inflammation around the anal area.
  • Discomfort or pain during bowel movements.
  • Bleeding, especially if the fistula becomes infected or irritated.
  • Fever or chills, which may occur if there is an accompanying infection.

It's important to note that not all fistulas cause symptoms. Some individuals may have asymptomatic fistulas that are discovered incidentally during a medical examination. If you suspect you may have a fistula in ano, it is best to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

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what are the Investigations of Fistula in Ano?

When diagnosing a fistula in ano, healthcare professionals may conduct several investigations to assess the condition. Some common investigations include:

  • Physical Examination: A thorough physical examination of the anal area is usually the first step. The healthcare professional will visually inspect the area and may gently probe the fistula tract to assess its depth, location, and extent.
  • Digital Rectal Examination (DRE): A DRE involves the insertion of a gloved, lubricated finger into the rectum to assess for any abnormalities, such as the presence of abscesses or other conditions that may be associated with the fistula.
  • Imaging Studies: Imaging techniques like ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scans may be used to obtain detailed images of the fistula tract and surrounding structures. These studies help in determining the course, depth, and complexity of the fistula.
  • Fistulography: Fistulography involves injecting a contrast material into the fistula tract to better visualize its path and branches. This procedure can help in identifying hidden tracts or complex fistulas.
  • Anoscopy or Proctoscopy: Anoscopy or proctoscopy may be performed to examine the anal canal and lower rectum using a specialized instrument. This allows for a closer inspection of the area to identify any associated conditions or abnormalities.

These investigations help in accurately diagnosing the fistula, determining its characteristics, and guiding the appropriate treatment plan. The specific investigations performed may vary depending on individual circumstances and the healthcare provider's preference.

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what are the treatment options for Fistula in Ano?

The treatment options for fistula in ano may vary depending on the complexity, location, and individual patient factors. Here are some common treatment options:

  • Fistulotomy: This is a surgical procedure in which the fistula tract is cut open and laid open to heal from the inside out. It is typically performed for simple or superficial fistulas.
  • Seton Placement: A seton is a thread-like material (usually a silicone or silk thread) that is placed through the fistula tract. It helps to keep the tract open, allowing it to heal gradually over time. This method is commonly used for complex or high-risk fistulas.
  • Advancement Flap: This surgical technique involves the creation of a flap of healthy tissue near the fistula opening, which is then rotated and used to cover the internal opening of the fistula. This procedure is typically used for higher or more complex fistulas.
  • LIFT (Ligation of the Intersphincteric Fistula Tract): LIFT is a procedure where the intersphincteric tract of the fistula is identified and ligated, cutting off its blood supply and promoting healing. It is commonly used for low-lying or transsphincteric fistulas.
  • Fibrin Glue Injection: In this minimally invasive procedure, a special glue-like substance is injected into the fistula tract to seal it and promote healing. It is generally suitable for simple or superficial fistulas.
  • Fistula Plug: A biologic or synthetic plug is placed within the fistula tract to promote healing. This method is typically used for certain types of low-lying fistulas.

The choice of treatment depends on several factors, including the type of fistula, its complexity, the patient's overall health, and the surgeon's expertise. It's important to consult with a healthcare professional or a colorectal surgeon who can evaluate the specific case and recommend the most appropriate treatment option.

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---- FAQs ----

Fistula in Ano

In some cases, small and simple fistulas may heal on their own, especially if they are associated with an abscess that has been properly drained. However, it is generally recommended to seek medical attention for a fistula in ano, as they often require surgical intervention to fully heal and prevent recurrence.

The treatment of a fistula in ano may involve some discomfort or pain, especially immediately after surgery. However, healthcare professionals typically provide pain management options to minimize discomfort. Pain medication, sitz baths, and maintaining good hygiene are commonly recommended to alleviate post-operative pain and promote healing.

Recurrence of a fistula in ano is possible, although the likelihood varies depending on the specific characteristics of the fistula and the chosen treatment method. Factors such as the complexity of the fistula, presence of underlying conditions like Crohn's disease, and surgical technique used can influence the risk of recurrence. It is important to follow post-operative care instructions, attend regular follow-up appointments, and promptly report any new or concerning symptoms to the healthcare provider for proper management.

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