RxMed: Illness Information

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General Illness Information

Common Name:

ANAL FISTULA

Medical Term:

None Specified.

Description:

An abnormal channel from the anus or rectum to the skin near the anal opening but may occasionally be to another organ such as the vagina. Most fistulas begin from a deep gland in the wall of the anus or rectum. However, fistulas may sometimes result from drainage of an ano-rectal abscess. The fistula may be painful and it may discharge pus. Fistulas in infants are usually congenital and are more common in boys than girls.

Causes:

Anal fistula can be caused by an infection, which starts in the anorectal crypts forming an abscess. Abscess bursts, leaving behind a tract from the interior to the anal opening.

Other causes include injury to the anus or rectum, inflammation of the bowel (e.g. crohn's diverticulitis) or cancer of the bowel.

Prevention:

No particular preventive steps.

Signs & Symptoms

	Constant or intermittent purulent discharge.
	Firm-tender lump.
	Pain during or after bowel movement.
	Discoloration of skin surrounding fistula.

Risk Factors

	Inflammatory bowel disease, such as crohn's disease.
	Infection (e.g. tuberculosis, diverticulitis)
	Puncture wound in anal canal lining or injury from an enema tip, injury during childbirth.
	Cancer of the bowel.
	Injection treatment for internal hemorrhoids.

Diagnosis & Treatment

Examination may reveal one or more openings around the anus and the doctor may be able to palpate a cord-like tract. A probe may be inserted to determine the depth and the direction of the fistula. Anoscopy (examination of the anus with an instrument) with probing may help reveal the primary opening. Sigmoidoscopy is also required to rule out concurrent bowel disorder.
General Measures:
Minor surgical procedure to excise fistula. Usually with local anesthetic (occasionally general anesthetic required).
	Warm sitz baths after surgery to help relieve any discomfort.

Medications:
	Stool softeners may be prescribed to prevent constipation.
	Antibiotics may be prescribed if an infection is present.

Activity:
Resume work and normal activity as soon as possible.

Diet:
	Regular diet, high in fiber.

Possible Complications :
	Constipation.
	Post-surgical bowel sphincter incompetence.
	Delayed wound healing in cases of underlying bowel disorder such as crohn's disease.

Prognosis

This condition is usually effectively treated by surgery unless underlying bowel disorder complicates it.