Fistula is a connection channel that normally should not exist between two organs in the anal area. Fistula channels seen in the anus area occur due to abscess formation of the organs in the area where they are formed or injuries in that area.
What is Anal Fistula?
Anal fistula is a structure that develops between the end of the intestine and the skin around the anus. An abscess, which usually occurs as a result of an infection around the anus, causes fistula formation. Fissures formed in the inner part of the anus pave the way for abscess formation because they are in contact with feces. Abscesses (crypt abscess) are also common due to infection of the glands at the anal exit. These abscesses move towards the skin around the anus and form a swelling. The abscess may burst spontaneously or it is required to heal by surgical drainage, but fistula may develop in the abscess areas where adequate healing is not achieved.
Symptoms of Anal Fistula
Anal fistula disease causes complaints in the anal area. The most common symptoms of anal fistula are usually swelling at the anal edge, a feeling of fullness, and in some cases severe pain due to abscess, bad odor, discharge and wetness.
Pain and bleeding during defecation or internal bleeding afterwards. Blood stains seen on underwear are also among the symptoms.
Anal Fistula Diagnosis
Since anal fistula is an anal disease that develops under the skin, a proctologist should definitely be consulted for a definitive diagnosis.
In the physical examination performed by the specialist physician, the discharge in the area thought to be a fistula and the external mouth of the fistula where the discharge comes from are investigated. The fistula line can also be felt by rectal touch. If necessary, the inner mouth of the fistula can be seen with anoscopy or rectoscopy. Seeing that the colored fluids given from the external mouth come from the anus supports the diagnosis of fistula. Fistula trace can be revealed with the help of a stylet.
Some fistula cases may have followed a much more complex path than it seems. For this reason, methods such as colonoscopy, fistulography, and pelvic MRI may be useful in the diagnosis process.
Anal Fistula Types
Anal fistula disease is named according to its location between the anus muscles. The target is classified. These fistula types;
Suprasphincteric Fistula: It opens from under the mucosa to the skin.
Intersphincteric Fistula: It progresses between the internal and external sphincters and opens to the skin. 45% of fistulas occur in this way.
Transsphincteric Fistula: It passes through the external sphincter and opens to the skin. 30% of fistulas occur in this way.
Suprasphincteric Fistula: It starts as intersphincteric but passes through the puborectal or levator muscle and opens to the skin. 20% of fistulas occur in this way.
Extrasphincteric Fistula: It passes outside all sphincters. It is 5% effective in the formation of fistulas.
Fistulas can also be classified as simple fistula or complex fistula. Simple fistula types are encountered in 70-75 percent of people with anal fistula disease. However, if the treatment is delayed, this disease process turns into longer and more difficult fistula structures.
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