An anal fistula is a pathological connection between the epithelium of the anal canal and the surface skin of the nearby perineal areas. This unwanted canal is most often the result of an infection of the anal glands, which can spread and create an abscess. An anal fistula can be simple, with only one canal and openings, or complex with multiple canals and branches.
Anal fistulas affect approximately 1–2 individuals per 10,000 people annually and are more common in men than women, with the highest incidence typically occurring between the ages of 30 and 50. Although serious, anal fistulas are treatable. Proper diagnostic and surgical methods, including modern technologies such as laser therapy, offer significant improvements in the quality of life for affected patients. Adhering to medical recommendations and ensuring proper postoperative care are crucial for successful recovery and a return to normal life.
An anal fistula is diagnosed by digital rectal examination, which can reveal internal fistula openings. Further imaging methods such as MRI, ultrasonography, or CT scans can help identify the extent and location of the fistula, or fistulography, an X-ray method using contrast material.
Symptoms
- Pain - one of the most common symptoms is chronic pain in the area of the anal opening, which is often exacerbated by sitting, bowel movements, or coughing
- Pus discharge - a constant or intermittent and very unpleasant discharge of pus may occur from the fistula opening
- Signs of infection - inflammation, swelling, and redness of the area may indicate infection
- Stool - possible incontinence or difficulty with bowel movements
- Antibiotic treatment
- Probiotics and fiber to improve intestinal flora
- Sitz baths with warm water (warm compresses)
Surgical treatment
- Fistulotomy - the incision necessary to open the entire fistula canal
- Seton drainage - the use of material to prevent premature closure of the fistula
- F.A.M.I.L.E. technology (Fistula of Anus Minimal Invasive Laser Excision) - an innovative and minimally invasive solution that ensures faster healing and lower risk of complications, utilizing cutting-edge laser technology to remove torn tissue and stimulate the natural healing process. It is performed ambulatory, often under local or short-term general anesthesia.
Basic information
- Care for the operated area is crucial. Clean thoroughly but gently
- Use of antibiotics to prevent secondary infections
- A diet rich in fiber, hydration, and probiotics to support healthy intestinal flora is recommended
- Suitable pain and constipation medications may be used for pain
- The complete healing time may vary depending on the extent of the fistula and the type of surgical procedure
- The length of recovery usually ranges from several weeks to several months
- Patients can often return to light activities after a few days and gradually increase physical exertion