Dr. Antonio Privitera

About Anal Fistula

Anal Fistula: Causes, Symptoms, Diagnosis And Treatment

The anus contains a small number of mucus-producing glands that are present between the internal and external anal sphincters. These glands open into the anus through a duct that may become blocked, leading to infection within the gland and subsequent formation of an abscess. This may extend through the muscles and form what is called an “anal fistula”.

Anal fistula may be associated with other diseases, such as Crohn’s disease, tuberculosis or tumors. It may also develop in infants, and it is often the result of a congenital defect. We know that you have many doubts and questions about fistula, let us answer them through this interesting article, read it carefully!

What is a Fistula?

It is the formation of an abnormal communication (tract) between two epithelial surfaces. A Fistula may occur as a result of various diseases, and may lead to serious complications that require surgical intervention. The most common type of fistula is anal fistula. Anal fistula is an abnormal communication between the skin and the inside of the back passage (anus).

How does an anal fistula look like?

An anal fistula initially appears as an external opening in the skin around the anal area. This external opening is usually inflamed and some secretions come out of it including blood. This may indicate the presence of an internal opening, therefore, the presence of a channel connecting the two openings. It is easy to determine the external opening of the fistula, but identifying the internal opening requires some special examinations and procedures carried out by a proctologist.

Anal Fistula Causes and Risk Factors

As we mentioned, there are many reasons that may lead to the formation of a fistula in the anal area. An abscess may form in the anal region within the anal glands, and this is the main reason for the formation of anal fistula. Other causes include:

  • Inflammatory Bowel Diseases (e.g. Crohn’s disease).
  • Radiation treatment.
  • Trauma.
  • Infections (e.g. Tuberculosis).
  • Cancer.
Anal Fistula Symptoms

Anal Fistula Symptoms

Symptoms of anal fistula, may vary from person to person, and their severity may increase or decrease depending on the severity of infection:

  • Feeling of pain around the anal area.
  • Presence of anal and perianal painful swelling.
  • Redness around the anal region.
  • Irritation of the skin around the anus.
  • Feeling pain during defecation.
  • Foul-smelling purulent discharge.
  • Bloody discharge.
  • Fever and chills.
  • Feeling tired and stressed in general.
Anal Fistula Causes and Risk Factors

The difference between pilonidal sinus and anal fistula

A pilonidal sinus can be confused with anal fistula as they are located close to each other. Pilonidal sinus appears over the sacro-coccygeal region as an opening that leads to a cavity. However, there is no connection with the anus, therefore, an internal opening is not present. A pilonidal sinus is often the results of ingrowing hair follicle that forms a pilonidal cyst. This may become infected with formation of an abscess that opens into the skin and appears as a pus-discharging orifice (sinus). The cavity of pilonidal sinus often contains hair. Hence the word “pilonidal” that means nest of hair.

Typical symptoms of pilonidal sinus is the presence of lower back pain with foul-smelling discharge. It is easier to treat a pilonidal sinus than an anal fistula as only the skin and subcutaneous are involved and not the anal sphincters.

What happens if you ignore anal fistula in case of infection?

Ignoring an anal fistula may lead to serious complications in case of ongoing infection. One of the possible complications, albeit rare, is sepsis, a serious condition that requires hospitalization and urgent treatment. Sepsis is a life-threatening condition that leads to failure of several organs in the human body. In the case of anal fistula, a proctologist should be consulted as soon as possible.

Anal Fistula Treatment in Dubai

In the event that the patient has been diagnosed with anal fistula, surgical intervention is needed to treat the anal fistula and prevent further complications. Surgical intervention is carried out by a surgeon who specializes in colorectal surgery (proctologist). A proctologist is able to treat the fistula avoiding the feared complication of anal incontinence (the inability to control the passage of stool).

There is no drug treatment for anal fistula, therefore, surgical intervention is the only solution.

Laser fistula treatment is one of the best and advanced definitive methods for treating fistula. It is best to have the surgery performed by a proctologist.

Laser closure of the fistula channel

After the patient is anesthetized, the laser probe is inserted into the external opening of the fistula and pushed gently towards the internal orifice. At this point the laser beam is activated and the probe pulled back to seal completely the fistula tract.

The high-temperature of the laser obliterates the anal fistula without causing damage to the muscles of the anal canal.

Anal Fistula Surgery: Why is laser preferred in the treatment of anal fistula?

It requires a skilled proctologist to make sure that the anal fistula is cured without damage to the anal muscles that would lead to the disabling complication of anal incontinence.

Laser treatment is a minimally invasive approach that avoids the risk of anal incontinence and has several other advantages:

  • Reduced operative time.
  • Reduced bleeding during surgery.
  • Reduced postoperative pain.
  • Faster healing.

For these reasons, Dr. Antonio Privitera, a specialist in colorectal surgery in Dubai, and an internationally well-known speaker at scientific conferences, recommends the use of laser for the surgical treatment of anal fistula.

You can book an appointment with Dr Antonio to discuss your symptoms and the best anal fistula treatment in Dubai.

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