Fistula treatment

Dr Ashish Bhanot
Anal fistula is an infected channel connecting the skin on buttock to an internal part of the anus, which forms as a result of an inflammation of one of the glands in the anus. In half of the cases it occurs due to the complication of Crohn’s disease affecting the intestines or diverticulitis.
Signs and Symptoms of Anal Fistula
* Pain, swelling and bleeding while passing stools
* Past incidence of having an anal absceses
* Pain in bowel movements, difficult in performing normal activities
* Redding on the opening of skin, discharge of pus
Diagnosis of Anal Fistula
A clinical evaluation including a digital rectal examination is well enough to diagnose anal fistula, but many a times test like MRI, ultrasound, protoscope, fistula probe and fistulogram are also done to understand the path of fistula.
Advance Treatment for Anal Fistula
There are numerous ways for treating anal fistula, some are conventional methods, which involves surgery and some are based on latest technology which doesn’t involve surgery. Depending upon the severity and the position of fistula the decisions are taken too apt for which kind of treatment. The aim of every treatment procedure is to end the pus forming processing without harming the control of bowel moments.
The most followed treatment practice by the doctors is the conventional method name Fistulutomy / Fistulectomy involving the removal of complete fistula tract with help of a knife. The process involves a lot of pain for the patient, because of large wound and patient requires long hospitalization and daily dressing of big wounds which usually take long time to heal and require daily treatment. It also has slightly higher chances of reoccurrence.
The pace of technology has changed the face of treatment in anal fistula, there have been ways that are better in terms of efficiency, results and doesn’t involve much pain. This new ray of hope in anal fistula treatment is Video Assisted Anal Fistula Treatment better known as VAAFT. This highly advanced treatment has given excellent results when comes to anal fistula treatments. A procedure which is painless with a high efficient rate and most important helps the patient to start his normal routine at a quick go. Doctor can identify the internal opening of the fistula tract with help
of an endoscope which navigates through the fistula tract under vision. The fistula is removed through a special electric current after the removal of the fistula the opening is shut, with the help of fibrin glue.
VAAFT has an extra edge over conventional treatments with lower rate of re-occurrence, muscles around anus are untouched which doesn’t create any problems while controlling motions and most important the treatment has no cut no pain, which makes it patient friendly and helps him to restart his normal life.
Anal Fistula Plug is another latest treatment in which Fistula plug, made up of of bodies collagen which is used to close the fistula.
You can avoid all of the above if you follow simple mantras to prevent anal fistula. The most crucial is to maintain anal hygiene, toilet hygiene, having sex with protection, avoiding spicy foods and excessive sedatives and pain killers.
(The author is Chief Bariatric Surgeon at Nova -Apolls group Hospital, New Delhi)