Perianal Fistula and Treatment Methods

What is Anal Fistula?

Although the breech region is a small region in the human body, the breech fistula shows much different mobility in the region. Unfortunately, as patients, we cannot take any protection or precautions regarding the cause of Perianal Fistula.

To explain, the internal muscles in the breech region, which is the last part of the intestine, consist of smooth or involuntary muscles. The outer muscle layer, on the other hand, is composed of voluntary and striated muscle fibers, taking on the task of holding the stool during stool. Of course, the roles of both muscles for defecation and gas retention are very important.

There are sweat glands and hair formations at the point where the breech canal meets the skin tissue. Perianal abscess causes inflammation of the sweat glands called seat glands in the inner muscle in the breech region. Or, to give another example, if we force that area, that is, the tissues in the breech region, cracks occur and an abscess is encountered in the rectum, since a clean structure is not formed during defecation.

While the inflammation collected in the body is tried to be eliminated and eliminated by the immune system, this perianal abscess infection is expelled from a region close to the skin. With the inflammation of these glands we have mentioned, tunnel formation is observed between the intestine and the skin tissue, and in this way, an unwanted channel is formed and a path is determined. As a result, the patient develops fistula discomfort. In this way, “What is a fistula?” question can be answered.

Anal Fistula Symptoms

Fistula symptoms are actually very specific. It may give symptoms in the form of swelling, fullness and sometimes odor in that area, that is, at the edge of the anus. In the following days or even weeks after the formation of anal fistula, spotting and yellow inflammation may be among the symptoms.

We can list these symptoms that trigger each other as follows:

  • Canal entrance due to anal fistula on the breech,

  • Inflammation in the rectum

  • Severe pain during toileting

  • Bad odor due to abscess caused by Perianal Fistula,

  • It is the appearance of blood during stool output.

What Causes Perianal Fistula?

In fact, rectal fistula is usually seen due to delaying the treatment of anal fissure disease. Failure to treat the cracks formed in the area due to conditions such as constipation or chronic diarrhea causes infection, that is, inflammation. Perianal Fistula is formed with abscess formation in this anus.

The formation of an abscess in the rectum and the drainage of this abscess out of the skin and on the skin occurs with the fistula channel that occurs spontaneously. In general, avoiding situations that cause the destruction of the region such as constipation and diarrhea (breech fissure, rectal abscess) can protect us from perianal fistula disease. Of course, fistula may not occur as a result of every constipation and diarrhea. But in general, it is seen as a result of the trauma of that region or an abscess in the breech. Apart from this, it can also be seen due to intestinal diseases. It can also be caused by diseases such as Crohn’s, ulcerative colitis and rectal cancer.

How is Anal Fistula Diagnosed?

The diagnosis of rectal fistula (anal fistula) is usually made as a result of a detailed rectovaginal examination or anal region examination performed by a specialist general surgeon. The protruding part of the anal fistula can be clearly seen on the edge of the anal region during the physical examination performed by the specialist physician.

There are many methods used in the diagnosis of rectovaginal fistula. However, as in every diagnostic phase, the patient’s anamnesis (patient history) should be taken in a healthy way. Questions such as when the discomfort started, the severity of the pain, and whether there was a previous attack can affect the method of fistula treatment and the method to be used for diagnosis. Therefore, correct answers should be given to the questions and the physician should be fully informed. After the anamnesis is completed, it is time for the methods used for definitive diagnosis. Some of those;

  1. Blue dye (methylene blue) test:It is used as one of the methods used to diagnose rectovaginal fistula.

  2. Anoscope Examination: Anoscope is the instrument used to diagnose breech disorders. Examination with an anoscope is called anoscopy. Since rectovaginal fistulas may be associated with the breech, the other end of the breech fistula canal can be determined by the physician with anoscope examination.

  3. Rectoscopy: Rectoscopy is performed with the help of an endoscopy device. Rectoscopy may be requested by the physician in cases where the anoscope provides the opportunity to view up to 10 cm. Thanks to its retroflexion feature, hemorrhoids (hemorrhoids) or anal fissures (anal fissure) accompanying breech fistula disease can also be detected by means of rectoscopy.

  4. Sigmoidoscopy: Sigmoidoscopy is the next step after rectoscopy. In this procedure, which is also performed with an endoscopy device, up to half of the large intestine is examined.

  5. Colonoscopy: According to studies, Crohn’s disease, which is an inflammatory bowel disease, is very effective in the formation of anal fistula and rectovaginal fistula. Therefore, the physician may request colonoscopy for differential diagnosis in suspected findings.

  6. Fistulography: Contrast material is injected through the fistula mouth during fistulography. Afterwards, the patient is x-rayed and information is provided about the structure of the fistula according to the distribution of the drug.

Perianal Fistula Treatment

Surgical methods with or without surgery appear as treatment in Perianal Fistula. Classical surgeries ask patients, “Will I lose my breech muscles or will my comfort be the same as before?” raises questions such as: A person suffering from rectal fistula suffers from great difficulties in social life. For this reason, it is of great importance how and by which method the treatment is performed. The important thing is not to damage the muscles in the breech area as much as possible. If it is treated without damaging the muscles; the patient can easily return to his own life and recovery is observed in a short time. Therefore, the selection and diagnosis of the treatment method is of great importance in Perianal Fistula.

What Happens If Anal Fistula Is Not Treated?

Regardless of whether it is operated or not, patients who think about the healing stages both before and after perianal fistula treatment and who have constant hesitations and hesitations about getting rid of this disease, unfortunately delay the treatment by prolonging this process. As one of the consequences of postponing the treatment process; We can show as an example that a type of fistula, which we define as simple rectal fistula, turns into a complicated type of fistula that almost surrounds the large intestine and causes a treatment that can be much more tiring for the patient. Especially in the surgical treatment of complicated fistulas performed with the classical fistula surgery method, the possibility of damage to the muscles in the anus, called the “sphincter”, which enables stool retention, can be quite high.

In addition, it should be kept in mind that some patients may experience conditions such as high fever and fatigue due to the increasing infection in the body due to an rectal abscess.

Related Posts

Leave a Reply

Your email address will not be published. Required fields are marked *