Types of Fistual in Ano
Fistulas are classified by their relationship to parts of the anal sphincter complex. They are classified as
- Intersphincteric is the most common anal fistula
- Transsphincteric
- Suprasphincteric
- Extrasphincteric is the least common anal fistula
Based on the complexity of fistula, risk of incontinence and risk of recurrence, it is divided into
- Simple fistula- They involve less than 30% of external spinchter.
- Complex fistula
- It involves more than 30% sphincter muscle.
- Complex fistula are associated with preexisting fecal incontinence, inflammatory bowel disease, or prior radiation.
- Crohn’s disease (an inflammatory disease of the intestine)
- Colorectal Cancer
- Radiation (treatment for cancer)
- Tuberculosis
- Sexually transmitted diseases
- Trauma
- Diverticulitis
- An opening on the skin around the anus
- Pain and swelling around the anus
- Bloody or foul-smelling drainage (pus) from an opening around the anus.
- Irritation of the skin around the anus from drainage
- Bleeding
- Frequent anal abscesses
- Fever, chills, and a general feeling of fatigue
- Doctor will examine the area around the anus and diagnose an anal fistula. He will look for an external opening on the skin. There can be drainage from the external opening. Doctor might advise MRI fistulogram of the anal area to get a better view of the fistula tract.
There are two main types of fistula surgery :
- Sphincter-Cutting Surgery
- Sphincter-Preserving Surgery (SPS)
- Fistulotomy
- Ligation of the intersphincteric Fistula Tract (LIFT)
- VAAFT
- FISTULA PLUG
- PILTEC
- FiLaC ( Fistula-tract Laser Closure)
- It is a minimally invasive surgery to keep the sphincter intact. On this procedure the anal fistula is removed by using laser energy. A flexible, radiating fiber-optic probe is inserted into the fistula tract from the outside. The laser energy burns the fistula tract. Then the laser is slowly withdrawn. The inflammatory tissue is destroyed in a controlled manner and the fistula tract contracts. The anal gland that originally caused the fistula is inactivated.
- Take sitz baths (sit for 15-20 minutes in warm water with antiseptic solution) three times a day and after each bowel movement for the first few days.
- Some amount of bleeding and discharge is normal.
- Avoid constipation.
- Take stool softener before bedtime every day till wound healing.
- Dry toilet tissue should be avoided. After bowel movements use water for cleaning, if possible, f.
- Apply ointment 2-3times per day.
- Eat a regular diet including plenty of fresh fruit and vegetables. Drink 6-8 glasses of water a day.
- Connect with fistula surgeon at Happy morning if your temperature is greater than 101 degrees, significant bleeding, and unbearable pain.
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