What is fistula?
It is the formation of a tunnel between the skin and the intestine around the anus, causing discharge.
What is the cause of this disease?
There are glands in the soft tissue around the anus. These glands discharge the secretion they produce into the last part of the intestine; Therefore, there are channels between the glands and the anus. If these glands become inflamed and an abscess occurs, the abscess will drain somehow. This discharge occurs either spontaneously by opening the abscess to the skin or the surgeon drains it surgically. In both cases, while the glands already have a channel into the intestine, they also merge with the skin, thus creating a tunnel between the intestine and the skin.
What are the symptoms?
Fistula patients. The most common complaint is purulent discharge. This discharge may occasionally soil the underwear with a drop or two, or it may be so much that it requires changing underwear several times a day. Since these discharges irritate the skin, itching may occur. Sometimes, when the discharge is red, it can be mistaken for bleeding.
How is the diagnosis made?
Diagnosis is quite easy. Just examination is enough. It may be necessary to perform some imaging examinations when the flow is stopped or in patients whose fistula hole remains inside the anus.
Which examinations should be performed?
The prevalence of the disease, where the fistula path leads, Some examinations such as MRI and colonoscopy can be performed to determine whether there is an abscess focus inside or whether there is a fistula due to another disease.
Is it necessary to have a colonoscopy?
If it is a simple fistula and we do not think of another underlying disease, colonoscopy may not be performed. However, if there is a recurrent fistula or if we are worried about another underlying disease, it is useful to have a colonoscopy.
Is it necessary to have an MRI?
An MRI is a must for every fistula patient. It is not. However, in recurrent fistulas, when it is thought that there is an abscess in the deep tissues, and if there is a multi-orifice fistula, it is useful to have an MRI.
Could these symptoms belong to another disease?
Anus with various diseases that cause the same complaints in the environment There are r. Among these diseases, piles (hemorrhoids) are very common. That's why people with these complaints often think they have hemorrhoids. However, there may be other diseases as well. Whether it is another disease or not can only be distinguished by examination and tests.
What is the treatment of fistula?
The treatment of fistula is surgery. It is essential to eliminate this unhealed tunnel during surgery.
What happens if surgery is not performed?
The disease continues, discharges and skin irritations progress. Rarely, fistulas that have been left untreated for many years can become cancerous.
Does the fistula turn into another disease?
In fistulas that have not been treated for many years, they can rarely become cancerous. Even though there may be a possibility of cancer.
Is there any treatment method other than surgery?
Drugs can reduce fistula discharge, but they cannot completely cure the disease. The main and definitive treatment of fistula disease is surgery.
In recent years, new methods have begun to be used for fistula treatment. The most important of these is shrinking and closing the fistula tract with laser. However, this method can be used in selected suitable patients and its success rate is around 60%.
What is done in the surgery?
The essence of the surgery is to eliminate this fistula tunnel. There is more than one surgical method for this purpose. The surgeon decides which method will be applied. Sometimes this tunnel is cut out in the shape of a cone, sometimes the tunnel is simply turned into an open wound and healed with dressings. Sometimes a fistula is removed to cut the anal muscles.
Is there any anal incontinence after the surgery?
In cases where the fistula goes behind the anal muscles and opens into the intestine, sometimes the anal muscles are removed. It also needs to be cut. However, since this cutting is done in the long term with a thread placed in the wound, the possibility of anal leakage is very low. If it is foreseen that there may be incontinence, the surgery method is planned accordingly.
Is a dressing required after the surgery?
Most patients do not need a dressing. But for people with large wounds, it would be better to have a gauze bandage on the anus at all times. This gland absorbs the currents and It prevents the laundry from getting dirty and helps healing by keeping the wound dry.
How long does it take for the surgical wound to heal?
A week to two months, depending on the size of the wound. It changes.
Will there be any changes in my life after the surgery?
I can return to a completely normal life. It is enough not to be constipated and to clean the wound after defecation. There is no limitation in taking a bath. Even if the dressings continue, the person can do his normal work.
When can I return to work?
Most patients return to work within a day or two. Sometimes this period may be a week.
Does the disease recur?
Anorectal fistulas are recurrent diseases. Because the hips are closed while the post-operative wound is healing, the wound lips come into contact with each other and the skin adheres quickly. But if the skin sticks and heals before the subcutaneous tissues heal, it already means fistula. Therefore, it is necessary to be in close contact with the physician while the post-operative wound is healing.
How can it be understood that the disease has recurred?
If the wound does not heal within the stipulated time or if the discharge starts again after healing. It can be said that the disease recurs in the wounds. But this must be confirmed by examination.
How is the treatment done if the disease recurs?
The treatment of recurrent fistulas is also surgery. But this time, an examination should be performed before the surgery to see if there is a reason that causes the fistula to recur.
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