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What is a Fistula?

A fistula is a small tunnel in the skin of the anal region. Whenever there is an infection inside the anus, a tunnel is formed to drain the pus which is the fistula.

What causes a fistula to form?

In majority of the cases, a fistula is formed when there is an infection in the anal region. Sometimes, it also forms because of sexually transmitted diseases, tuberculosis or any illness that affects the bowels. Some fistulas also form during childbirth.

Symptoms / when to call your doctor:

You must reach out to your doctor if you have:

  • Pain

  • Swelling and bleeding

  • Discharge of pus from the anal region

Why you should see a doctor?

A fistula is a common, simple problem to fix, but it does not go away by itself. You have to see a doctor to treat it.

Ignoring the symptoms can lead to:

  • Acute pain

  • Recurring infections

  • Cancer

  • Organ failure

  • Nerve damage

How is it diagnosed?

Fistulas can be easily diagnosed by a physical examination. To understand if there are any other complications, the doctor might ask for an X-ray, CT scan or a colonoscopy report.

Dietary Restrictions

It is best to have simple, bland, low fat food like rice, toast, yoghurt etc after the surgery. Increasing the intake of fibre rich food and water is recommended.

Treatment for a Fistula

You need to see a doctor to treat a fistula. It does not heal by itself. A fistula cannot be treated by medication. If the fistula is small, the doctor can clean it up in the clinic with a local anaesthesia. But, if it’s large, you’ll need a surgery to resolve it.

Types of treatments:

SpecificsTraditional SurgeryLaser Surgery
Cuts and WoundsYesNo
Dietary RestrictionsYesSmall modifications in diet
Recovery Time2-4 days24 hours
Blood LossYesNo

Traditional Procedure

There are several procedures which involve cutting though the anal region to seal the fistula.

Some of the procedures are:

  • Fistulotomy: The entire length of the fistula is cut and opened so that it heals like a cut

  • Seton Technique: A cut is made in the anal region and a surgical thread is placed in the fistula to help it to drain out slowly and heal on its own

  • Flap Procedure: A cut is made in the fistula through which it is drained. A flap is used to cover the fistula to help it heal. The flap is made of tissue taken from a healthy part of the rectum.

  • LIFT procedure: The fistula is cut and sealed at both ends and the rest of it is kept open to heal

All of these procedures require cutting and suturing which results in a longer and slower recovery.

Recovery Time and Dietary Advice:

  • Hospital stay of 2-4 days or longer

  • Resume normal day routine after 4-6 weeks

  • Liquid diet for a couple of days after which solids can be introduced

Risks involved in the treatment:

These procedures involve cutting through the anal region. So, some of the risks may be:

  • Injury to the anal area

  • Excessive bleeding

  • Infection of the surgical wound

  • Faecal or urinary incontinence

  • Blood clots

  • Risks of general anaesthesia

Laser Procedure

This procedure involves the use of laser technology. It’s a no cut, no wound procedure which is completed in 30 minutes.

Flow of the procedure:

  • Patient is given general anaesthesia for the procedure

  • A small laser emitting device is inserted through the anus

  • The stone is removed directly from the incision

  • The energy from the laser is directed towards the fistula to seal it completely

  • The laser device is removed

Recovery Time and Dietary Advice:

  • 1 Day procedure with mild pain

  • Resume normal routine from next day

  • Simple, bland, nutritious, fibre rich food

There are very less complications through this laser treatment. Some of the risks may be:

Some of the risks of the procedure may be:

  • allergic or adverse reaction to anaesthesia or other drugs

  • Bleeding

  • blood clots

  • damage to blood vessels

  • incontinence