What is Anal Fistula?
Although the anal area is a small area in the human body, anal fistula shows much different mobility in the region. Unfortunately, as patients, we cannot take any protection or precautions regarding the cause of Perianal Fistula.
To explain, the internal muscles in the anus region, which is the last part of the intestine, consist of muscles that work straight or involuntarily. The outer muscle layer consists of voluntary and striated muscle fibers that undertake the task of retaining the feces during defecation. Of course, the roles of both muscles for defecation and gas retention are very important.
There are sweat glands and hair formations at the point where the anal canal meets the skin tissue. Perianal abscess causes inflammation of the sweat glands called seat glands in the inner muscle of the anus area. Or, to give another example, if we force that area, that is, the tissues in the anal area, cracks form, and since a clean structure is not formed during defecation, an abscess is encountered in the anus.
The inflammation collected in the body is determined by the immune system. While trying to be removed and destroyed, this perianal abscess infection is thrown out from an area close to the skin. With the inflammation of these glands that we have mentioned, tunnel formation is observed between the intestine and skin tissue, and in this way, an unwanted channel is formed and a path is determined. As a result, the patient develops fistula discomfort. In this way, “What is fistula?” The answer to the question can be answered.
Anal Fistula Symptoms
Fistula symptoms are actually very specific. It may cause symptoms such as swelling, fullness and sometimes odor in that area, that is, at the edge of the anus, in the anus. Yellow inflammations along with spotting may be among the symptoms in the following days or even weeks after the formation of an anal fistula.
We can list these symptoms, which occur by triggering each other, as follows:
-
Anus. canal entrance due to anal fistula on it,
-
Inflammation in the anus,
-
Severe pain during toilet,
-
It occurs due to Perianal Fistula Bad odor due to an abscess.
-
The appearance of blood during stool passage.
What Causes Perianal Fistula?
Anal fistula is actually usually seen as a result of postponing the treatment of anal fissure. Failure to treat cracks that occur in the area due to conditions such as constipation or chronic diarrhea causes infection, that is, inflammation. Perianal Fistula occurs with this situation of abscess formation in the anus.
The formation of an abscess in the anus and the abscess draining out of the skin and draining onto the skin occurs with the fistula channel that occurs spontaneously. In general, avoiding situations that cause damage to the area (anal fissure, anal abscess), such as constipation and diarrhea, can protect us from perianal fistula disease. Of course, fistula may not occur as a result of every constipation and diarrhea. But in general terms, it is seen to be caused by trauma to that area or an abscess in the anus. Apart from this, it can also be seen due to intestinal diseases. It can also be caused by diseases such as Crohn's, ulcerative colitis and cancer in the anal area.
How is Anal Fistula Diagnosed?
The diagnosis of anal fistula (anal fistula) is usually made by a specialist. It is diagnosed as a result of a detailed rectovaginal examination or anal region examination performed by a general surgeon. The protruding part of the anal fistula can be clearly seen on the edge of the anal area during the physical examination performed by the specialist physician.
There are many methods used in the diagnosis phase for rectovaginal fistula. However, as in every diagnostic stage, the patient's anamnesis (patient history) must be taken as a priority. Questions such as when the discomfort started, the severity of pain, whether there have been previous attacks may affect the type of fistula treatment and the method to be used when making the diagnosis. Therefore, correct answers should be given to the questions and the physician should be fully informed. After the anamnesis is completed, it is time to use the methods used for definitive diagnosis. Some of these are;
Blue dye (methylene blue) test: It is used as one of the methods used to diagnose rectovaginal fistula. r.
Anoscope Examination: Anoscope is a tool used to diagnose anal disorders. Examination performed with an anoscope is called anoscopy. Since rectovaginal fistulas may be connected to the anus, the other end of the anal fistula canal can be determined by the physician through anoscope examination.
Rectoscopy: Rectoscopy is performed with the help of an endoscopy device. Since anoscope allows imaging up to 10 cm, in cases where it is not sufficient, rectoscopy may be requested by the physician. Thanks to its retroflexion feature, hemorrhoids or anal fissures that accompany anal fistula disease can also be detected by rectoscopy.
Sigmoidoscopy: Sigmoidoscopy is different from rectoscopy. is the next step. In this procedure, which is also performed with an endoscopy device, up to half of the large intestine is examined.
Colonoscopy: According to research, Crohn's disease, an inflammatory bowel disease, causes anal fistula and rectovaginal problems. It is very effective in fistula formation. Therefore, the physician may request colonoscopy for differential diagnosis in case of suspicious findings.
Fistulography:During fistulography, contrast material is injected from the fistula mouth. Afterwards, an x-ray is taken to the patient and information is provided about the structure of the fistula according to the distribution of the drug.
Perianal Fistula Treatment
In case of Perianal Fistula, surgery with or without surgery These methods appear as treatments. Classic surgeries ask patients, "Will I lose my anal muscles or will my comfort be the same as before?" It raises questions such as: A person suffering from anal fistula suffers from great difficulties in social life. Therefore, it is of great importance how and with what method the treatment is performed. The important thing is not to damage the muscles in the anus area as much as possible. If it is treated without damaging the muscles; The patient can easily return to his/her own life and recovery is observed in a short time. Therefore, the selection and diagnosis of the treatment method are of great importance in Perianal Fistula.
Anal Fistula. What Happens If It Is Not Treated?
Regardless of whether it is surgical or non-surgical, patients who think about the healing stages both before and after perianal fistula treatment and have constant indecisiveness and hesitations about getting rid of this disease, unfortunately, prolong this process. postpones treatment. As one of the consequences of postponing the treatment process; We can give an example when a fistula type that we define as a simple anal fistula turns into a complicated fistula type that almost surrounds the large intestine and causes a treatment that can be much more tiring for the patient. Especially in the surgical treatment of complicated fistulas performed with the classical fistula surgery method, the possibility of damage to the muscles in the anus, called "sphincters", which enable the retention of feces, may increase considerably.
In addition, some patients experience high fever and weakness due to the increased infection in the body due to an abscess in the anus. It should not be forgotten that situations such as this may occur.
Read: 0
