What Is Anal Fistula?

Further check if you have experience other anal fistula symptoms as stated below:
Frequent smelly abscesses (pus) leakage
Passing blood or pus during bowel movements
Irritation of the skin around the drainage opening
Pain or tenderness around anal region while sitting down, moving around or during bowel movements
Pain with bowel movements
Fever

These are the common anal fistula symptoms. Same as other diseases, everyone may experience different symptoms. One may suffer from one symptom only, or could be all symptoms.

By now, you will have an idea when you shall see a doctor for an advice on anal fistula treatment. Contact us today if you wish to have recommendations of the nearest hospital and doctors.

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WSM Medic Website: https://wsmmedic.com/treatment-laseranalfistula/

what is anal fistula?

An anal fistula is an abnormal tract that is lined with granulation tissue and that connects a primary opening inside the anal canal to a secondary opening on the perianal skin. The opening on the perianal skin can often be tiny – so small that many people may not be aware of it.

The formation is the result of an infection in the anal glands causing a collection of pus (abscess) in nearby tissue. Occasionally, bacterial, fecal material or foreign matter can clog the anal gland and create a condition for an abscess cavity to form.

In many cases, an anal fistula involves on single tunnel connecting the inside of the anus/rectum with the skin around the anus. Sometimes, the abscess will drain on its own and leave a small channel behind. In some cases, disease is more complex whereby the abscess might cause formation of “secondary tracts” or branches out if the abscess is trapped inside the tunnel, or some might have multiple tracts, potentially with more than one opening on the skin.

Types of Anal Fistula

Fistulas are classified by their relationship to part of anal sphincter complex. Based on Park’s classification, there are 4 main types of anal fistulas: inter-sphincteric (most common), trans-sphincteric, supra-sphincter and extra-sphincteric.

Inter-sphincteric fistula begins between internal and external sphincter muscle, passing through the internal sphincter (does not cross through external sphincter muscle) and open very close to the anus.

Trans-sphincteric fistula begins between internal and external sphincter muscle, crossing through the external sphincter and open an inch away from the anus.

Supra-sphincteric fistula is normally formed between internal and external sphincter muscle, extend above and cross the puborectalis muscle then descending through the puborectalis muscle and levator ani muscles and open an inch away from the anus.

Extra-sphincteric fistula begins at the rectum or sigmoid colon which develop downward, crossing through the levator ani muscle and open into the skin around anus.

Submucosal fistula passes superficially beneath the submucosa and do not cross any sphincter muscle.

Signs That You Might Have Anal Fistula

Fever
Frequent anal abscesses
Pain or tenderness around anus when you sit down, move around or during bowel movements.
Bloody or foul-smelling drainage (pus) from an opening around the anus
Irritation of the skin around the anus from drainage
Pain with bowel movements
Passing blood or pus during bowel movements
Difficulty in controlling bowel movements

Shall seek advice from doctor if you notice any of these symptoms.

An anal fistula most often happens from an anal gland that has developed a pus-filled infection (abscess). A fistula can also happen with certain conditions such as inflammatory bowel disease (e.g. Crohn’s disease, ulcerative colitis), systemic diseases (e.g. Tuberculosis, diabetes, HIV) or chronic diarrhea.

Anal Fistula Treatment Options

To cure an anal fistula, surgery is almost always necessary. Conventional treatment options in treating anal fistula are fistulotomy and fistulectomy, which the former is a surgery cutting open the skin and muscle around the tunnel to an open groove for healing/often require dividing a small portion of the sphincter muscle, the latter is a complete excision of fistulous tract.

Advancement flap (AF) procedure is another method in treating anal fistula whereby the mucosal tissue beyond the internal opening of fistula is being cut open, lift up and ligate with internal opening. The external opening is left open, allowing the pus to be drained.

Additionally, ligation of inter-sphincteric fistula tract (LIFT) procedure is an alternative to AF, in which the fistula tract is identified in the inter-sphincteric space. Once identified, the skin around the tract is being cut open, followed by ligation of the whole fistula tract using dissolvable suture.

The Latest Minimally-Invasive Treatment,

Laser Anal Fistula

It is a new minimally-invasive treatment method for anal fistula without cutting out the tract. The sphincter muscle which is responsible for continence is spared and not cut to prevent incidence of incontinence.

During the procedure, a highly flexible laser fibre is passed through the external opening, along the fistula tract and through the internal opening. Precise laser energy was delivered homogeneously at 360 degree at the fiber tip, ablate the endoluminal granulation tissue and close the epithelial wall of the fistula tract simultaneously like a zipper, without harming the surrounding muscle fibres of the sphincters.

Minimally Invasive

No big open wound as no cutting out or removal of fistula tract.

Muscle Sparing

No incontinence issue as tiny Laser fibre (1.8mm) is inserted into the tract and closed the tract internally.

Fast Recovery

Faster tissue repair as only a small opening is required for the insertion of Laser fibre into the fistula tract to close it. Patient can recover and return to normal activities faster.

Frequently Asked Questions (FAQs)

1. What shall I need to prepare before surgery?

Doctor might suggest to place a draining seton over your fistula to drain the discharge accumulated in the tract, stimulate growth of new epithelial lining of the fistula track as well as create a homogenous calibre of fistula along its entire length.

2. How long do I need to stay in hospital after surgery?

Normally patient will be discharged after 1 night stay in the hospital.

3. Patients choosing this treatment will benefit from the following advantages:

A sphincter-sparing method that preserves anal continence without the risk of incontinence
Minimally invasive surgery as compared to conventional method, no cutting out of fistula tract
Fast recovery and able to return to normal activities

In conclusion

What is Anal Fistula? It is an abnormal tract that is lined with granulation tissue and that connects a primary opening inside the anal canal to a secondary opening on the perianal skin. Laser Anal Fistula Treatment is a minimally invasive treatment method without cutting out the tract. During Laser Procedure, the sphincter muscle which is responsible for continence will not be cut or injured, as a result the risk of incontinence is very minimal.