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Anal fistula
What will happen if an anal fistula is not treated?
An anal fistula is a chronic fistula and duct caused by an infection of the anal sinuses. If not treated, an anal fistula may repeatedly flare up. The consequences of repeated occurrences can lead to abscesses, peripheral spreading, and eventually extensive spreading of the loose tissue around the anus, which in severe cases may damage the anal muscles, leading to anal incontinence. If an anal fistula persists for a long time, there is also a possibility of malignant transformation.
Which is more serious, anal fistula or hemorrhoids?
Anal fistulas and hemorrhoids are two different types of common colorectal diseases; neither can be said to be more severe than the other, as the severity of each disease depends on its progression and extent. If it's a simple superficial anal fistula, the severity is generally mild, primarily treated with surgery. However, if a high, complex anal fistula is present, in addition to surgery, a comprehensive pelvic MRI examination is also required to rule out any infections in the deep sphincter and ischioanal fossa. The severity of hemorrhoids primarily involves circular mixed hemorrhoids, or those accompanied by incarceration. If circular mixed hemorrhoids with incarceration occur, it is advisable to undergo surgical treatment as soon as possible to avoid necrosis. If hemorrhoids result in persistent and significant rectal bleeding, surgery should also be performed promptly to prevent anemia in the patient.
Is the probability of anal fistula turning into cancer high?
An anal fistula, formed due to an anal gland infection, carries a higher risk of malignant transformation if the infection and inflammation are recurrent and persistent, particularly over a long period exceeding five years. Therefore, it is strongly recommended that anal fistulas exceeding five years should be given sufficient attention and surgical treatment should be pursued promptly to prevent malignancy.
Anal fistula etiology
The cause of an anal fistula is due to infection of the anal glands. In normal human anatomy, there is a location at the junction of the rectum and the anal canal called the anal sinus or anal gland, which is relatively weak. If it is damaged, intestinal bacteria can enter the anal gland, causing inflammation. Over time, the infected anal gland leads to further abscesses towards the perianal space, causing a perianal abscess. After the perianal abscess ruptures, it further develops into an anal fistula.
How long will it take for a fallen anal fistula seton to heal?
The primary surgical method for anal fistulas is the fistulotomy with seton placement. The duration for which the seton, made of elastic band, remains in place largely depends on the severity of the anal fistula and the amount of sphincter muscle tied. If the fistula is a simple superficial one, the seton usually falls out around seven days. In cases of high, complex anal fistulas, or those with multiple branching fistula tracts and multiple sphincters tied, the seton may take slightly longer to fall out, generally about ten days. If the seton has not fallen out after the local sphincter muscle has fully regenerated, it can be cut by a professional proctologist. However, it is important to note that postoperative care mainly involves dressing changes until the seton falls out, indicating that the wound has largely healed.
Can people with anal fistula drink alcohol?
Patients with anal fistula are advised not to drink alcohol. As an anal fistula already features distinct external and internal openings as well as a fistulous tract, excessive or chronic alcohol consumption can stimulate recurrent local inflammatory episodes. This can cause an increase in the secretions from both openings, leading to varying degrees of anal pain and itching for the patient, worsening the condition, potentially increasing the branches of the fistula, or causing it to spread deeper or to other areas. Therefore, not only should patients with anal fistula abstain from alcohol, but they should also maintain a light diet rich in green vegetables and fruits. Once diagnosed, it is crucial for patients with anal fistula to undergo surgical treatment promptly. The primary surgical approach involves fistulotomy with seton placement. Postoperatively, attention must be paid to the dressing of the local wound to avoid pseudo-healing and infection.
What color is the pus from an anal fistula?
An anal fistula is a sinus tract and fistula formed from an infection of the anal sinuses and glands. During the infection phase, there is a possibility of swelling, pain, and pus discharge. This discharge may be yellow pus or pus mixed with blood. Regardless of the color, it is crucial to seek prompt medical treatment at a hospital and undergo thorough treatment, rather than attempting conservative treatment on one's own.
What department should I see for anal fistula?
Anal fistula is caused by infection of the anal sinuses and glands. It manifests as hard lumps or cord-like objects around the anus, and may involve recurrent swelling, pain, and discharge of pus. In such cases, it is necessary to consult a colorectal surgeon. Generally, if diagnosed with an anal fistula, surgical treatment is required, as conservative treatment usually does not result in a cure.
The difference between perianal abscess and anal fistula
Perianal abscesses and anal fistulas both belong to local infectious diseases of the anus. A perianal abscess represents the acute phase of infection, characterized by significant localized subcutaneous swelling, heat, pain, and the formation of pus and abscesses. Once the pus breaks through the skin and discharges, it naturally forms an anal fistula. Anal fistulas represent the later stages or dormant phases of local infections. Both perianal abscesses and anal fistulas require surgical treatment. The surgical method for perianal abscesses mainly involves a one-time radical surgery for the abscess, while the surgical approach for anal fistulas primarily involves fistulotomy with seton placement, followed by regular wound cleaning and dressing changes post-surgery.
How to relieve pain from anal fistula?
The main reason that anal fistulas cause pain is because they are severe infectious lesions. During the acute phase, local inflammation causes pain or itching around the external opening, along with discharge from this opening. To alleviate the pain caused by anal fistulas, one can first apply anti-inflammatory ointments to temporarily relieve the symptoms. It is also important to maintain cleanliness around the anal area. Hemorrhoid suppositories can be used to ease the inflammation in the anal and intestinal tract. However, to completely cure the pain from anal fistulas, besides conservative medication, surgical treatment is often necessary. The main surgical method for anal fistulas is fistulotomy with a seton placement, which thoroughly removes the local infection and prevents the recurrence of pain.