An anal fistula is an
abnormal track between the mucosa (internal lining) of the anus and the
skin outside the anus.
A fistula usually develops
after drainage of an anal abscess but may occur spontaneously. Discharge
of pus may be constant or intermittent as the external opening on the
skin may heal temporarily.
A fistula is not related
to cancer.
Most fistulae are the
result of infections in an anal gland. In India it may be associated
with Tuberculosis. It is also associated with Inflammatory bowel
disease.
Surgery is needed to cure
a fistula. The course of the track between the anus and the skin has to
be identified and exposed.
Fistulotomy opens the
length of the track to the skin's surface allowing the open wound to
heal slowly. Some sphincter muscle is divided. This is the most requent
treatment employed. A Seton is a loop of flexible material placed along
the track to maintain drainage for a period of time. Seton placement is
a type of treatment reserved for complicated fistulae.
Sometimes examination
under anaesthesia may be necessary to assess the process of healing.
Most operations for fistulae are performed in hospital.
After the surgery the
patient is usually discharged on the next day of surgery and is
regularly called for follow-up. Anal Abscess
