Are you experiencing pain and swelling around the opening of your anus? There is a good chance you have an anal fistula, and you should visit your doctor as soon as possible for a diagnosis.
What Is An Anal Fistula?
An anal fistula is a small tube connecting an abscess (infected cavity) in the rectum to the hole of the anus. Your anus is the opening where you expel feces from the body.
Inside this hole lies multiple small glands that expel mucus. These glands can get blocked, which leads to infection, creating an abscess. These abscesses can develop into a fistula.
Causes And Symptoms
1. What Are The Causes And Anal Fistula?
The most common cause is blocked anal glands, which lead to abscesses.
However, there are other causes which include:
The Symptoms Of An Anal Fistula
If you experience any of these terrible symptoms, you may have an anal fistula:
- Fever, chills, and fatigue
- Frequent anal abscesses
- Pain and swelling around the anus
- Pain when excreting feces
Bloody and nasty-smelling pus is coming from the opening of the rectum.
- Pain may subside once the fistula drains.
- The drainage causes irritable skin around the anus.
How is an anal fistula diagnosed?
An anal fistula is typically diagnosed during a physical examination by your physician. They will feel around your anus and lower rectum for any lumps or masses and feel for lumps around these areas to detect an anal fistula if suspected.
Should they suspect you may have one, additional tests may be run to verify this possibility, such as:
- Anoscopy: An anoscopy allows your doctor to examine the skin around and inside of your anus for any potential issues, such as anal fissures and abscesses.
- Rectal exam: Your doctor may use a lubricated finger to examine your rectum for lumps or masses.
- Sigmoidoscopy: Under sigmoidoscopy, a thin and flexible tube is inserted into your rectum so your doctor can examine tissue samples inside of your bowel.
types of fistula surgery
There are several different types of surgery for anal fistulas:
1. Anal fistula excision
Anal fistulas can typically be treated through excision surgery. A surgeon will make a small incision on the anus skin and use sutures or staples to cut away any scar tissue that might be contributing to an anal fistula problem, and also take this opportunity to eliminate any enlarged veins around it. Following surgery, patients must apply a topical cream or ointment as post-care to aid healing.
2. Perineal fistulotomy
Perineal fistulotomies are an additional treatment option for anal fistulas. This procedure entails making an incision in the skin near your anus and extracting any scar tissue that might be causing problems while your surgeon examines blood vessels for any enlarged veins in this area. Often performed as outpatient procedures, perineal fistulotomies may require multiple follow-up appointments under anesthesia if complications or additional issues arise during recovery.
Fistulectomy is a surgical process to eradicate all or part of an anal fistula. Your physician will make an incision over your anal canal and extract any tissue forming on it, such as mucosa and muscle tissue, if necessary.
Constipation can strain your bathroom trips and lead to complications. Here’s how to prevent it without medication:
- Fiber-Rich Diet: Add more fresh veggies and fruits to your meals. Drink plenty of water for regularity, reducing stress from irregular bowel movements.
- Consult Your Surgeon: Talk to your surgeon about Lactulose, but ensure you have a valid prescription for its effectiveness.
- Alternatives: If lactose isn’t suitable, discuss other laxatives and stool softeners with your physician. They can help you find the right fit for your needs.
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fistula surgery for dialysis
Fistula surgery for dialysis creates an integral link between an artery and vein to facilitate effective blood filtration during dialysis sessions. While catheters or grafts might offer temporary solutions, AV fistulas offer greater durability with lower clotting risks than their alternatives.
At surgery, a surgeon makes a small incision in your arm to connect an artery to a vein, then sutures it shut afterward. Your fistula then develops over several weeks until you’re ready for dialysis treatment.
Once their fistula has matured, patients can visit a dialysis center for treatment. Two needles will be inserted into their fistula, one to remove blood while returning filtered blood back into their bodies.
- Longer lifespan compared to other access methods.
- Reduced clotting and infection risks.
- Better blood flow for efficient dialysis.
- While generally safe, surgery carries standard risks like bleeding and infection.
Anal fistula surgery cost
Costs associated with anal fistula surgery vary based on factors like complexity, type of procedure performed, surgeon fees and location considerations, as well as insurance. Here is an outline:
- UK: Typically ranges from £5,000 to £10,000.
- USA: Generally falls between $5,000 and $10,000.
- Turkey: Typically ranges from $2,000 to $5,000.
Turkey often provides lower costs due to lower living and medical expenses. Furthermore, Turkish hospitals and surgeons typically specialize in this procedure and may be open to discussing prices with you directly; remember, individual cases may differ.
fistula surgery recovery
Most of these surgeries are effective. Once you are home, taking a long soak in a warm bath will help you feel better, called a sitz bath. However, do the bathing sparingly, as this can cause unnecessary discomfort.
You will also need to take stool softeners or laxatives for several days to ensure you don’t irritate the affected area. However, ensure not to wipe the area too much with toilet paper as this can irritate your anus.
Most people experience discomfort or pain after their procedure, and your doctor will likely inject you with a numbing agent that will help.
You can also use pain medication to alleviate the pain. However, if your surgery and recovery go as planned, it is scarce that the anal fistula will return.
For the ladies, you can use sanitary towels for some extra padding. I recommend the thin or ultra-thin nighttime options. Stick them to the back of your underwear instead of the front.
Other factors to take note of:
- Avoid too much activity like walking long distances or running.
- Avoid lifting objects that weigh more than 5kg for at least two weeks, such as children or heavy shopping bags.
The patient should perform no sexual activity for at least two weeks. Sticking items into your anus or vagina (like tampons) can cause damage to your rectum and even dislodge the seton.
After two weeks, see how you feel. If you feel like you are ready for sexual intercourse, then go ahead, but still, ensure you don’t dislodge the seton.
It is essential to avoid constipation as this can cause unnecessary strain when going to the bathroom. This strain can undo the seton and potentially cause complications or damage.
If you don’t want to take medication, you can incorporate extra fiber into your diet, like fresh vegetables and fruits, and drink a lot of water to loosen your bowel movements. This will also help you be more regular.
You can also purchase something called Lactulose, designed to lose bowel movements. Again, it would help if you discussed this with your surgeon, as a prescription is required.
If you can’t consume lactose, there are other laxatives and stool softeners available, and you can discuss these products with your doctor to see which one will work for you.
Surgery at the best prices
Packages include all medical fees, accommodation, airport transfers, and personal hosts.
What Are The Risks Associated With Anal Fistula?
There are some risks associated with anal fistula surgery, which include:
- Severe pain that over-the-counter pain medication might not be able to treat.
- Continuous bleeding
- The seton dislodging
When You Should Call Your Healthcare Provider
If you experience any of the following distressing signs after your procedure, you must consult a doctor, especially if you have had issues with anal abscesses in the past. If any of these symptoms arise, seek out medical help immediately:
- A fever of 100.4 degrees Fahrenheit or higher
- Symptoms of the anal fistula return, like pain or drainage
- Severe pain, inflammation, swelling, or drainage in or around the anus or rectum
- Issues with controlling your bowel movements
- Hard or painful stools
- Mucus, pus, or blood in your stool will result in a dark or bright red color.
- Stomach pain isn’t relieved with medication and lasts more than a few hours.
- Continuous nausea or vomiting
If these signs persist even after seeing your doctor, it might be time for a second opinion. Seek a physician who has completed advanced surgical and non-surgical procedures and colon, rectum, and anus problems.
fistula surgery success rate
Success rates of fistula surgery depend on its purpose; for dialysis fistulas, success has been estimated between 70-90% and 90% depending on which procedure was used; anal fistula procedures typically have anywhere from 60%-90% success rates depending on which approach was taken.
As individual outcomes may differ significantly between individuals, you must discuss expectations with your healthcare provider prior to proceeding with any surgery procedure.
An anal fistula is a small tube connecting an abscess (infected cavity) in the rectum to the hole of the anus. Causes can include blocked anal glands, which lead to abscesses, trauma, cancer, Crohn’s disease, radiation, or sexually transmitted diseases.
To diagnose an anal fistula, your doctor must examine the area around your anus. If they can’t see anything outside, other diagnoses can include ultrasounds or MRIs, Anoscopy, or a surgical inspection.
Treatment for an anal fistula is usually surgery, but other procedures include placing a seton, a fistulotomy, an advancement flap procedure, and a lift procedure.
To ensure you are recovering correctly, take sitz baths 3-4 times a day (keep them short) and add extra fiber to your diet. In addition, take Lactulose or laxatives, avoid wiping your anus too much, wear sanitary pads for extra comfort, avoid physical activity for the first two weeks, and have no sexual intercourse for 14 days.
Risks associated with this procedure include severe pain, continuous bleeding, the seton coming undone, and infection.
After your surgery, you should seek medical attention if you experience a fever of 100.4 degrees Fahrenheit or higher, pain or drainage, inflammation or swelling in or around the anus, problems with your bowel movements, mucus, blood secretion, and continuous vomiting.
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Frequently Asked Questions.
How do you heal a fistula without surgery?
Healing a fistula without surgery can be challenging and often requires medical management, antibiotics, and lifestyle modifications in order to control symptoms; however, full healing without surgical intervention remains rare.
How long does fistula surgery take?
Fistula surgery typically lasts several hours. The exact duration will depend on its complexity and type.
Can a fistula come back after surgery?
Yes, fistulas may return after surgery; however, the chances of this occurring depend on various factors like the type of procedure performed and the health status of the individual patient.
Is fistula surgery painful?
Surgery to correct fistulae is typically conducted under general anesthesia, so you won’t experience any discomfort during or after the process. After surgery, there may be some discomfort after recovery, which can be managed with prescribed medications.
Is fistula surgery dangerous?
Fistula surgery carries some risks, including infection, bleeding, or structural damage to nearby structures; however, when performed by an experienced surgeon in a properly equipped facility it’s generally considered safe.
How is fistula surgery done?
Fistula surgery entails creating an alternative path for fluids to drain properly, using procedures such as fistulotomy, fistulectomy, seton placement, or advancement flap repair in order to block off an abnormal tract and close it off.