A fistula is an abnormal tunnel between two bodily structures that are hollow, like blood vessels, intestines or other hollow organs.
Fistulas can be caused by an infection, an injury, a surgery or an inflammation. The treatment depends on the cause and extent of the fistula but mostly, a fistula is repaired by surgery combined with antibiotic treatment.
Of all the fistulas, anal fistula or fistula-in-ano is the most common.
What is Anal Fistula?
An anal fistula is a small tunnel that runs from an infected gland in the anus to an opening on the skin around it. It is usually the result of an infection near the anus causing a collection of pus in the nearby tissue. When the pus oozes out, it can leave a small channel behind.
Anal fistulas do not get better on their own. Surgery is recommended in most cases.
Your doctor will conduct the following to diagnose your disease:
Reviewing your Medical History
Your doctor will initiate the diagnosis by examining your past medical history, signs and symptoms.
Your doctor will examine the fistula opening. The tenderness and drainage of pus near the anal region will be determined by gently pressing around the fistula. Some fistulas can be easily spotted, while others are not visible. Some fistulas close spontaneously and then open back up.
It is easy to locate an external opening but quite challenging to detect an internal opening. So your doctor may recommend a rectal examination.
A finger covered with a glove and lubricated gel is inserted into the anus and rectum to find out:
the functioning of the sphincter muscles (muscles that allow you to control the stool)
area of infection
extension of fistula
Further tests that are performed to decide on the appropriate treatment are:
A proctoscope is used to see inside the rectum.
The fistula tract becomes clearly visible.
It is generally used in multiple or recurrent fistulae. A pelvic MRI is 90% accurate in mapping the fistula tract and identifying internal openings.
It helps in determining the extent of inflammation.
Anal canal is examined with a scope.
Blood test, X-rays and colonoscopy are used to find if the fistula is related to Crohn's disease (a long-term condition in which the intestine becomes inflamed).
Most common symptoms are:
A constant throbbing pain that increases during bowel movements
Redness, swelling, soreness and itching around your anus
The other symptoms noticed are:
Bleeding or passing pus during bowel movements
Fever, chills and a general feeling of fatigue
A foul-smelling liquid oozing from an opening near your anus
Difficulty controlling bowel movements
Irritation of skin around the anus from drainage
The most common cause of anal fistula is:
There are several glands just inside your anus which make fluid. Sometimes they get blocked. As a result, there is bacterial growth which creates a swollen pocket of infected tissue and liquid. This is called an abscess. If it is not treated, it will grow. Finally it will make its way outside and punch a hole near the anus and drain out the ooze inside. The fistula is the tunnel that connects the gland to that opening.
The less common causes are:
Sexually Transmitted Diseases
Ulcerative Colitis (inflammation of the digestive tract)
A complication of surgery near the anus
Radiation therapy for rectal cancer
Trauma in the anal region
Diverticulitis ( small pouches form in the large intestine and become inflamed)
The conditions that increase the risk of developing anal fistulas are:
Previous history of anal abscess or fistula
Body mass index greater than 25
High daily salt intake
Smoking and alcohol intake
Less physical activity
Excessive intake of spicy/ greasy food
Dermatosis (inflammation of the skin)
Hyperlipidemia (high levels of cholesterol and triglycerides in blood)
Treatment of fistula in Ayurveda
Ayurveda has effective methods for treatment of fistula.
According to Ayurveda, imbalance of any of the three doshas is responsible for fistula. Through customized treatment and lifestyle modifications, the doshas are balanced and the body is rejuvenated.
The following two parasurgical procedures are adopted for the treatment of fistula:
Kshara Sutra therapy
It is a minimally invasive, safe and cost-effective treatment procedure that offers a faster healing and recovery period.
In this therapy, the doctor initiates the procedure by administering local anaesthesia. A thread or probe called kshara sutra, coated with various combinations of medicines, is passed through the anal canal. It is then gently taken out through the anal opening to form a groove and both of its ends are tied together. The coating on the thread is released gradually and it simultaneously cuts, curettes, drains, cleans and heals the fistula. The probe is replaced after a week. This is continued for five weeks.
Kshara Karma Therapy
In small low anal fistulas, the fistula tract is cut and kshara, obtained from the ashes of Apamarga plant is applied over the internal mass.After two minutes, its colour turns to reddish black. It is then burnt and washed with lemon juice and a rectal pack is applied. It is a mild and superior procedure.
In high level fistulas, both therapies are adopted.
Treatment of fistula at Jeevess
At Jeevess, the parasurgical procedure, Kshara sutra and the milder Kshara Karma therapy are used for the treatment of anal fistula.This is the method of caustic cauterization that uses herbs.
The treatment is safe,painless and very effective. The chances for recurrence and infection are reduced. You can maintain your regular lifestyle post treatment. There is no surgical complication. There are no side effects. The treatment is not at all expensive.