What is anal fistula?

Article written by TS.BS Nguyen Thai Binh - Gastroenterologist - General Surgery Department - Vinmec Ha Long International Hospital

Anal fistula is a chronic infection in the anorectal area, the fistula is a tunnel, inside is the granulation tissue created by the chronic inflammatory process.
Anal fistula is the result of an untreated perianal-rectal abscess bursting to form a fistula, so anal fistula and rectal abscess are 2 stages of a pathological process, abscess is the stage Acute, anal fistula is the chronic stage. To prevent anal fistula, it is necessary to detect and treat peri-rectal abscesses well.

Anal fistulas always originate from anorectal abscesses that are not treated at the right time or with the wrong technique.

The common bacteria when cultured in the anal fistula are intestinal bacteria such as E.coli, streptococcus, staphylococcus. In addition, anal fistula can be caused by tuberculosis, in this case, the patient needs to be examined and treated for tuberculosis thoroughly before handling the fistula to achieve results.

Symptoms of anal fistula are often seen after a period of time, the adnexal anal abscess spontaneously ruptures, the wound closes with dry scabs, sometimes bursts into a small hole with foul yellow discharge or pus, this process is repeated many times. .
Local examination shows firm surrounding tissues, painful pressure, examination or analoscopy may find an internal fistula.

There are many ways to classify anal fistula, which helps surgeons propose the most suitable surgical method and predict the treatment outcome. Includes:
Complete leak: Clearly identify 2 internal and external fistulas to create a complete fistula. Incomplete fistula (clicky fistula): Only 1 fistula (internal or external) has been identified. Complex fistula (horseshoe fistula): The fistula has many nooks and crannies, many openings to the skin. Simple fistula: Straight fistula with few nooks and crannies.

Fistula in the sphincter: A superficial fistula is the result of a subcutaneous abscess near the anus, treatment is often less recurrent. Transsphincter fistula: A fistula passing through the sphincter is often the result of an abscess in the rectal fossa. External sphincter fistula: It is the result of an abscess in the pelvis and rectum. In order for the anal fistula removal surgery to be effective, the surgeon should be provided with as much information as possible regarding the fistula anatomy, its shape, characteristics, and the surrounding pelvic structures. core. Therefore, in addition to contrast-enhanced fistula or local ultrasound, magnetic resonance imaging (MRI) to determine the morphology of anal fistula is increasingly indicated to support diagnosis and plan surgery. more effective.
Magnetic resonance imaging allows to provide more detailed and accurate information about the anal fistula, surrounding soft structures such as sphincter, ligament, and associated abscesses, if present. Magnetic resonance imaging is also useful to evaluate the results after the treatment process.

The only treatment for anal fistula is surgery. In order for the patient to be completely cured and not recur, the following requirements must be met:
The internal fistula must be found. Must remove all fibrous organization with nooks and crannies. Minimize damage to the sphincter because it will cause incontinence. Choosing the right surgical method Post-operative care must be guaranteed from the inside out, from the bottom up.

For a simple fistula located not too close to the anus, the doctor will make an incision and the muscle surrounding the tunnel, drain the pus, and drain the fistula clean.
For more complicated fistulas, the doctor may place seton in the fistula to drain pus and secretions from the infection during surgery. Seton time can last from 6 weeks or more.
This disease, if not treated early and properly, will lead to many serious complications that adversely affect health. Therefore, patients should not be shy to hide from going to the doctor or choosing treatment at unreliable medical facilities.
Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, modern equipment and technology, but also stands out for its examination and consultation services. comprehensive and professional medical consultation and treatment; A civilized, polite, safe and sterile medical examination and treatment space to help patients get definitive treatment to quickly bring them back to normal life.
For detailed information, please contact the hospitals and clinics of Vinmec health system nationwide.

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