What is Anal Fistula? What are the Causes of Anal Fistula?

An anal fistula is a small inflamed tunnel that opens from the abscessed area in the anus wall to the skin around the breech hole.

Patients come with complaints of pain and swelling in the breech region. Anal fistula may be in the form of a single channel or may consist of several channels in the form of tree branches.

However, the paths through which these channels pass are very important because there are muscles in this region that are very important in human life in terms of their functions.

Anal fistula is often the result of a previous or existing abscess. Anal abscess is the accumulation of pus around the anus as a result of inflammation.

Anal fistulas may arise from these abscesses, or they may develop due to reasons such as chronic intestinal disease and radiotherapy.

• Pain and swelling in and around the anus
• Itching and burning in the anus
• difficulty sitting
• Redness in the rectum
• Feeling of fullness in the anus
• Foul-smelling or bloody discharge around the rectum
• soiling in underwear
• Fire
• painful urination
• There are symptoms such as constipation.

When constipation is experienced with fistula, occasional abscess attacks can be seen. If surgery is avoided and occasional abscess attacks occur, new tunnels may form.

This can complicate the disease. Fistula patients should be careful not to be constipated. For this, plenty of water should be drunk and fibrous foods should be consumed.

The most important cause of rectal fistula and abscess is inflammation of the glands under the skin and between the muscles in the anus. This disease has many symptoms. These symptoms are:

Acute diarrhea attack, trauma caused by foreign body and hard defecation, inflamed anal fissures, inflamed anal hematomas, intestinal parasites, pinworms in the anus, Crohn’s disease, tuberculosis, diverticulitis, ulcerative colitis, tuberculosis, intestinal fungi, cancers, intra-abdominal inflammations and serious genital infections.

The diagnosis of anal fistula is mostly made by examination. The course of the disease around the anus, whether it is complicated or not, whether there is chronic bowel disease and how the surgery will be performed can be determined by the following diagnostic methods.

• magnetic resonance imaging
• Rectosigmoidoscopy/ Colonoscopy
• fistulography

Anal fistula types are shaped according to the structure of the fistula and its spread rate. Most of the anal fistulas are simple fistulas and their progression is inevitable if left untreated.

When the fistula progresses, it gives serious problems to the patient and this makes treatment difficult.

Types of anal fistulas include:

• Intersphincteric Anal Fistula: Almost most of the anal fistulas are this type of fistula. It is a type of fistula that spreads towards the skin surface by passing through the muscles around the anus.
• Transsphincteric Anal Fistula: It is a type of fistula that spreads towards the skin surface by passing the outermost muscle that controls the anus.
• Suprasphincteric Anal Fistula: It is a type of fistula that goes towards the skin surface by passing all the muscles surrounding the anus.
• Extrasphincteric Anal Fistula: It constitutes a small part of anal fistula disease and is a type of fistula without inflammation in its origin.

In today’s conditions, there is still no medical treatment for anal fistula. Surgical treatment is always required in this pathology. If the fistula contains a small part of the sphincter muscle, a fitulotomy is performed.

Fitulotomy is the process of opening the skin and cutting a small part of the anal sphincter that connects the external and internal mouth of the fistula and transforming the passage into a wound that will then heal in a controlled manner.

It can be performed during surgical abscess drainage. In some cases, the fistula may appear after the first drainage. However, some of the sphincter muscle fibers are also removed during this procedure, and some deterioration may occur in the defecation ability of the patients.

In addition to this method, there are other surgical methods in which the sphincter muscles are not cut. Fibrin glue is one of these options. In this method, fibrin glue is squeezed into the fistula line and this canal line is filled.

Since the sphinker muscle is not cut, there is no problem in defecation. The disadvantage of this method is the low success rate. However, it can be applied more than once as an advantage.

Unless the fistula is treated, it branches off over the years. In this case, treatment becomes more and more difficult. The ongoing inflammation process in this region can lead to cancer.

Due to the presence of continuous inflamed discharge, fungus develops around the anus. In addition, there is constant itching in the anal area.

With the non-surgical anal fistula treatment, this disease can be treated in a short time like 10 minutes, pain is not felt after the treatment, no incisions and stitches are used in the treatment, complaints such as tissue loss and abscess are not observed, and the patient can return to his social life on the same day.

People who want to have this surgery are hesitant about the risks of surgery and the undesirable effects in the healing process.

As in every surgical operation, there is a risk of complications at a rate of one in a thousand in anal fistula operations. Anesthesia risks are as much as they can be in every operation.

The situation that people are afraid of after anal fistula surgery is stool incontinence and gas production. There are many treatment methods for anal fistula.

Complications and postoperative complaints in anal fistula treatments performed today are very low.

It is used in medicine for the treatment of many different diseases. It has been shown that it can also be used in the treatment of fistula for the last 3-4 years, and it has been used successfully.

Although it is performed in operating room conditions, it does not cause pain to the patient like other surgeries. A fistula is a tubular opening between a hollow organ and the skin, or between two hollow structures (such as between the large intestine and the genital area).

In perianal fistulas between the intestine and the rectum, the probe of the laser is inserted from the outer mouth of the fistula to the inner mouth, while the probe is slowly pulled outward, light is given along the canal.

This light comes from burning the inner surface of the fistula, in a sense. The inside of the canal burns and is destroyed.

Instead of this destroyed tissue, the body develops new, clean and healthy tissue. This new tissue that develops occludes the opening, in other words, it closes it.

Those Who Have Laser Fistula Surgery:

• They are extremely comfortable after the procedure.
• They do not endure dressings for a long time.
• They do not have problems such as bleeding.
• They can return home the same day or the next day.
• They can get back to work in 2-4 days.
• They do not experience problems such as gas incontinence and stool incontinence.

Prevention from anal fistula is possible with nutrition, cleaning and regular defecation. Sub-headings to prevent anal fistula disease are as follows: nutrition, regular defecation and cleaning.

Nutrition: Nowadays, when our eating habits are directed to fast food and not enough vegetables, fruits and fiber foods are consumed, constipation or diarrhea occurs. This triggers the anal fistula. To prevent anal fistula, the first thing to do is to change the eating habits.

Regular Defecation and Cleaning: Delaying defecation for a long time causes hardening of the stool and the force experienced during defecation leads to the destruction of the anus. Anal fistula can be prevented by using plenty of water and choosing soft toilet papers for cleaning after defecation.