A fistula of the anus (it is also called a fistula) is a passage formed in the region of the anus. Most often, this phenomenon is a complication of paraproctitis, when a fistula is formed as a result of prompt or spontaneous opening of an existing abscess. The causative agents of this pathological process can be various infectious agents, in some cases there is a tuberculous etiology.
When the passage opens into the lumen of the intestine and out through the skin, a complete fistula of the anus is diagnosed. In the case when the passage opens either into the lumen of the intestine, or through the skin in the anus, we can speak of an incomplete fistula. Depending on how the fistulous passages relate to the sphincter of the
anus, the fistulas are divided into those that are inside it, pass through it or are located outside of the sphincter.
Fistula of the anus: symptoms
Symptoms depend on the nature of the fistula. So, if there is an incomplete external fistula, a person will experience itching, irritation, slight pain, constant humidity in the anus. Soreness increases with bowel movements. A person can feel that in his anus there is some kind of foreign body. With a complete fistula, pus impurities can be observed in the feces.
When the fistulous opening closes, the patient's condition worsens: the pain intensifies, the temperature rises. If the pathological process proceeds for a long time, irritation of the surrounding integument of the skin begins, in men, the scrotum becomes inflamed, in women, the labia (large). The skin in the anus area is compacted, which makes the bowel movement even more painful due to injuries to the skin.
Fistula of the anus: diagnosis
If there is an external fistulous opening, diagnosis will not be difficult. It is visible with the naked eye - in the anus you can notice a small swelling of the granulation tissue. If you press on the surrounding area, a drop of pus will appear. To conduct an investigation of the fistulous passage (to determine its length, direction, number of branches, etc.), methods such as sounding, examination with a rectal mirror, and radiography are used (contrast agents are introduced into the fistulous passage).
There are some signs that allow us to differentiate fistulas of tuberculous etiology from pararectal fistula. The former are characterized by thin and saped edges of the fistulous opening, a cyanotic shade of the surrounding
skin, and pale granulations.
Anus fistula: treatment
Depending on how the fistula is anatomically located, the choice of surgical treatment method will also be carried out. But in any case, only surgery will allow getting rid of the disease. Fistula of the anus is usually dissected along the entire length of the course, antibiotics are administered, then the wound is sutured. After that, a special tube is placed in the lumen of the intestine, with the help of which gas will be removed in the postoperative period. Further therapy is to take medications that increase the strength of the body. Also, much attention should be paid after surgery to nutrition - the patient is prescribed a diet that includes only those products that are almost completely absorbed in the small intestine.