Subscribe
Anal fistula
Can colitis cause anal fistula?
If it is chronic colitis, it is possible to cause anal fistulas. Most patients with chronic colitis have symptoms of unformed stools and loose feces. Some feces, which are relatively thin, tend to accumulate in the anal crypts, leading to infection of the anal glands in these areas. The inflammation then spreads to the normal soft tissues around the anus, including subcutaneous tissues, forming perianal abscesses. If a perianal abscess ruptures or is surgically incised to release pus, the external opening and the pus cavity gradually heal and narrow, thus forming an anal fistula. If chronic colitis is diagnosed, it should be promptly diagnosed and treated to prevent the formation of anal fistula.
Will anal fistula cause bleeding during bowel movements?
If an anal fistula occurs, during the acute phase of the anal fistula, or when the internal and external openings of the anal fistula are ulcerated, there may also be bleeding during defecation. However, the bleeding from defecation due to an anal fistula is generally minor, and occasionally pus may also be discharged from the anus, or pus may be discharged from the external opening, causing itching or stinging of the skin around the external opening. If local pain or bleeding from defecation occurs with an anal fistula, prompt local anti-inflammatory treatment is needed; an anti-inflammatory ointment can be chosen for local application. However, the fundamental treatment for an anal fistula still requires surgery. It is generally recommended to directly perform a fistulotomy with seton placement to completely heal the fistula and prevent recurrent episodes.
What are the symptoms of anal fistula?
An anal fistula generally refers to a tract left behind after an anal abscess bursts on its own or is surgically opened. It usually consists of a primary internal opening and a secondary external opening. The main clinical manifestations, or primary symptoms, are: The first is discharge of pus, which occurs due to recurrent infections in the anal fistula; The second is pain. When the external opening is closed, the pus inside cannot drain properly, or when drainage is poor, this leads to accumulation of pus in the fistula tract, causing localized pain; The third is itching. Continuous irritation of the skin around the external opening by pus draining from the fistula tract can cause itching around the anus and may lead to symptoms like anal eczema.
What are the symptoms of anal fistula?
The clinical symptoms of anal fistula are mainly manifested as intermittent discharge of secretion from the local external opening near the anus, accompanied by varying degrees of pain in the anal area, and occasionally, pus is expelled with the stool. The main reason for its formation is that the anal fistula not only has an external opening, but also an internal opening near the dentate line of the anal canal. The internal opening discharges pus intermittently due to the stimulation of local inflammation. The composition of an anal fistula includes the internal and external openings, as well as the fistula tract that connects them; therefore, simply using medication cannot completely eliminate this lesion. The treatment of anal fistula is mainly surgical, aimed at removing the local lesion, with the principle of preserving the anal sphincter to avoid damage to it, which could affect the patient's future life.
Can anal fistulas be contagious?
An anal fistula is a pathological channel that forms a connection between the anal canal, rectum, and the skin around the anus. It primarily develops from an infection causing a perirectal abscess around the rectal anal canal. These infections are generally purulent, with a smaller number due to tuberculosis. Other specific infections, such as Crohn's disease or ulcerative colitis, can also lead to anal fistulas. Generally, such infections are caused by Escherichia coli, leading to purulent infections; tuberculosis can be contagious, but generally, it is not infectious or contagious.
What are the consequences of not treating an anal fistula?
If an anal fistula is not promptly treated with surgery, it may lead to an increase in the number of local branches or a thickening of the fistula wall. If the branches of the anal fistula extend to the ischiorectal fossa, it may also lead to pelvic infections. Moreover, if the anal fistula persists for a long time or if there is significant local inflammatory stimulation, it may even lead to cancerous changes in the fistula. Therefore, once an anal fistula is discovered and diagnosed, it is recommended to promptly undergo surgical treatment with fistulotomy and seton placement. Post-surgery, it is crucial to ensure thorough disinfection of the local wound, debridement, and dressing changes, which are very important for the recovery of the wound. This helps prevent pseudohealing, ensuring that the anal fistula heals completely and preventing recurrent episodes.
Can a twenty-year anal fistula turn into cancer?
Firstly, anal fistulas can become cancerous. Statistical data show that the probability of malignant transformation in anal fistulas is 1/1000, and such transformations are relatively rare in clinical practice. However, anal fistulas can change, but the timing of malignant transformation varies. Generally, the longer the duration of an anal fistula, the higher the chance of it becoming cancerous. The factors contributing to this transformation typically include chronic inflammation, long-term irritation, bacterial infection, and stimulation from medications, all of which can lead to cancerous changes.
Are hemorrhoids the same as anal fistulas?
Hemorrhoids and anal fistulas are two completely different diseases. Clinically, hemorrhoids can be divided into mixed hemorrhoids, internal hemorrhoids, and external hemorrhoids. Internal hemorrhoids are often characterized by intermittent, painless rectal bleeding, while external hemorrhoids primarily cause symptoms such as a foreign body sensation in the anus and itching. For the treatment of hemorrhoids, if the condition severely affects the patient's normal life, surgical treatment can be considered, such as external peeling and internal ligation surgery, and internal hemorrhoid banding. Anal fistulas are mainly due to perianal abscesses that rupture spontaneously or are incised and drained, subsequently forming an anal fistula, which causes the patient to experience recurrent perianal swelling pain and pus and bloody discharge. Treatment for anal fistulas can only be surgical, and early surgical intervention tends to result in relatively fast postoperative recovery. The surgery mainly involves the removal of the internal opening and the fistula tract, followed by diligent postoperative dressing changes to promote wound healing.
What are the precautions after undergoing anal fistula surgery?
Because anal fistula surgery primarily involves removing the internal opening and the fistula tract, the postoperative wound is relatively large. Postoperative care mainly requires consistent dressing changes to ensure the wound drainage remains unobstructed, avoiding infection or false healing. Additionally, patients should develop good bowel habits, maintain smooth bowel movements, and avoid withholding stool. Otherwise, this may lead to dry, hard stools, causing severe pain during defecation or damaging the wound, which could result in bleeding or edema. In terms of diet, patients should choose foods rich in roughage to ensure smooth defecation and eat foods rich in high-quality protein to supplement the amino acids the body needs, promoting wound healing as much as possible. Moreover, after surgery, patients must use an anal wash or potassium permanganate solution for sitz baths. Since the postoperative wound is open and contaminated, changing dressings is especially important.
Should surgery be performed if there are no symptoms of anal fistula?
If an anal fistula is in its acute phase, the main clinical symptoms are intermittent discharge of pus from the external opening, or pain and itching. If there are no symptoms, and only the external and internal openings along with the fistula tract exist, surgery is still required because the absence of symptoms temporarily does not guarantee that an acute episode will not occur later. During an acute episode, there will be local tissue and skin inflammation, redness, heat, and severe pain. If an anal fistula is not surgically treated for a long time, it may lead to an increase in the number of branches of the fistula or thickening of the fistula wall, and it may even spread to the pelvic cavity. Therefore, once an anal fistula is discovered, it is necessary to perform surgery as soon as possible. Early treatment has significant benefits for wound recovery and the difficulty of the operation.