It is an abnormal connection between your anal canal (back passage) to the surrounding skin. It can occur due to various reasons explained below.
Most fistulas are caused by simple hair follicle infection that was not treated completely/properly.
There are millions of hair follicles in one's body. Any one of them around the anal canal can get infected. Infection is more in people who sit for long time and more so among those who sit in unhygienic or hot/sweating environments (e.g., long-distance drivers). When the infection occurs and there is pus collection, the pus needs to be drained properly for the chances of fistula formation to decrease drastically.
If pus is not drained properly, then the body has to discharge the pus, and there are only two directions. If it bursts out of skin and infection gets completely cured, then a fistula does not form. If it bursts into the anal canal, then a fistula is formed. Worst case is when it bursts into the skin but residual infection spreads slowly in different directions. In such a case, a complex fistula is formed. There are certain conditions such asCrohn'sthat predispose one to having fistula. These conditions are rare in India.
Fistulas can be classified depending on the involvement of sphincter muscles and internal opening as shown in the picture.
A fistula might be characterized by recurrent discharge of pus around the back passage, which stops and starts. People end up taking antibiotic each time, and with time, the fistula will become more complex and difficult to treat. If there is a collection of pus, then it canbe present at in the form of an abscess. In this case, the abscess needs to be treated first and then fistula at a later stage.
The only way to cure a fistula is by surgery. Most fistulae are simple and do not involve sphincter muscles, so cutting it out fully will cure the fistula.
Low fistula can be treated with laying it open which is a simple procedure with minimal complications.
LASER in FISTULA SURGERY
LASER has now revolutionised treatment of Anal Fistula.
LASER in fistula surgery is the newer way of dealing troublesome condition. It has several advantages over other procedures like
If one has fistula that involves sphincter or opening is away from the anal verge then LASER procures will be helpful as the wound will be minimal leading to less pain and faster recovery.
There are different methods of using LASER in Fistula surgery and it can be combined with other treatment modalities like Vedio Assisted Anal Fistula Treatment (VAAFT) leading to higher success rates while causing minimal pain and disruption to one's work life balance.