Fistula of the rectum often appears due to paraproctitis and other pathologies of the intestinal tract. A person can sometimes not notice the symptoms of the disease or write them off to other conditions of his body. Such behavior can lead to proliferation of the anal fistula, suppuration and inflammation of the surrounding tissues. Such a disease is not treated independently, surgical intervention will be required.
So, why does the fistula occur after surgery?
Pathology Description
Fistulas are canals that extend to the anus from the intestines. They either enter the internal organs in the neighborhood, or go outside. Such channels are often filled with infiltrate and pus, microbes and feces penetrate into them. The inflammatory process in many cases concerns neighboring tissues and other intestinal parts.
The hole is surrounded by scar tissue at the output of the fistula in the wound after surgery, and it also grows. Infiltrate and pus are still absent. Scar tissue leaves, but abscesses occur. The fistula canal is characterized by a large number of abscesses and branches. Infiltration is present in the fistula.
Of course, anorectal fistula is a serious problem for patients, but if untreated, complications can bring even more trouble. That is why it is necessary to timely diagnose a fistula after surgery, mainly at the initial stage of the formation of the disease, and then it will be easier to respond to therapy.
Causes of occurrence
Pararectal or anorectal fistula mainly appears after untreated or transferred paraproctitis. However, there are also other reasons for the formation of fistulas, namely:
- The surgeon’s mistake when paraproctitis is treated, however, with surgical intervention, the affected areas are not completely removed.
- Intestinal diseases (Crohn's disease, hemorrhoids, anal fissures, diverticulitis).
- Complications after removal of the hemorrhoidal node (muscle fibers sutured).
- Injuries in the rectum that were received on their own or during medical diagnostic procedures.
- Syphilis, chlamydia.
- Intestinal tuberculosis.
- Intestinal malignant tumors, especially in the rectum.
- Female injuries after childbirth.
How long the fistula heals after surgery is interesting to many.
The problem is often exacerbated with prolonged chronic constipation, when a fistula begins to appear. Feces, not capable of timely exit from the body, clogs this passage and produces toxins. Because of this, the fistula after the operation develops more actively, the process itself becomes more complex.
Signs of pathology
Symptoms of this pathology are often expressed to such an extent that they simply cannot be confused with signs of other diseases. Patients complain of the following manifestations:
- pain in the lower abdomen and in the rectum;
- discomfort in the anus, which intensifies with bowel movements;
- pus is released from the exit of the fistula, traces remain on underwear and clothing;
- aggravation of the condition of already existing anal fissures or the formation of new ones;
- decreased performance and general weakness;
- the presence of pus and blood impurities in the feces, a characteristic unpleasant odor;
- irritation of the anus with discharge from the fistula, the appearance on the skin in the perianal and anal region of the rash;
- increase in body temperature;
- due to pararectal fistulas, the female genitals are inflamed, which is accompanied by purulent vaginal discharge, discomfort, pain;
- problems in men with sexual life.
Patients cannot tolerate such symptoms for a very long time, therefore they seek to contact a proctologist for help with the purpose of excising a fistula in order to eliminate the problem that causes anxiety and other symptoms of rectal disease.
Diagnostic Methods
Fistula after surgery can be diagnosed quite simply while collecting a medical history, as well as examining the intestines with a finger. But in order to confirm the diagnosis and establish the true cause, specialists use additional diagnostic methods, which include:
- sigmoidoscopy, that is, examination of the rectal region through a probe;
- colonoscopy - examination of the colon and rectum by means of a probe with the ability to collect material for biopsy;
- ultrasonography - analysis of the rectum using an ultrasound machine, in which the tube is directly inserted into the intestine and ultrasound is supplied from the inside;
- staining the anus with a dye that is inserted into the rectum, so that you can determine the fistula during observation of the filling and subsequent distribution of the introduced substance into the intestine;
- fistulography - an x-ray of the rectum is performed using a contrast medium;
- sphincterometry - makes it possible to determine the performance of the anal sphincter;
- microbiological analysis of secretions directly from the fistula or from the rectum allows you to see the presence of a bacterial infection that accompanies the disease;
- CT is performed in cases where the fistula gives complications to adjacent organs.
Diagnostic methods make it possible to establish the correct diagnosis and identify the causes of the fistula in the presence of extraneous intestinal diseases. It is also necessary so that the specialist can tell the patient how to treat directly the fistula of the rectum, and other concomitant pathologies and complications.
Treatment of this pathology
It is impossible to get rid of a fistula at home with the help of folk remedies. Even drugs do not in all cases provide a positive result. A fistula with a minimum probability can go away by itself, in a similar situation, in no case should one rely on chance, since the consequences of untreated pathology can be fatal.
Surgical intervention
The main way to treat a fistula after surgery is surgery. Therapy without surgery can only be in one case, when fibrin glue is poured into the fistula passageway until it is completely filled with further suturing of the two holes of the intestinal fistula. But such treatment does not guarantee absolute recovery and the impossibility of the formation of new fistulas, in particular, without eliminating the initial pathological cause.
Fistula excision surgery
Surgery consists in excision of the fistula and drainage of existing abscesses. In the process of excision, it is very important not to affect healthy tissues and to clearly operate only on the affected area. The operation to eliminate the fistula in the rectum is performed under general anesthesia. Those. the patient simply sleeps and does not feel pain.
Postoperative period
This is a very important stage for a person to recover and prevent possible relapses. It is necessary to adhere to a number of recommendations.
After surgery to remove the rectal fistula, bed rest and antibiotic treatment are prescribed for 7 to 10 days. The patient is contraindicated in bowel movements for 4 to 5 days, which is done to avoid injury to the closed canal by feces.
It is only allowed to drink water and decoctions, glucose is administered intravenously. Then the menu consists of broths, semolina on the water, boiled fish, steam cutlets. All food without salt and seasoning. Drinking is not limited. After a few days, you can add dairy products, vegetable and fruit purees on the water, baked apples. The exceptions are legumes, fresh vegetables and fruits, carbonated drinks.
If after 5 days there is no bowel movement, a cleansing enema is performed.
Dressings are regularly applied, ointments are allowed to relieve pain after surgery. After each bowel movement, sedentary baths are shown using furatsilina, miramistin.
Sutures (if any) are removed after 7 to 10 days. It takes two to three weeks to completely heal the wound.
The treatment lasts approximately two weeks. To prevent the recurrence of a pathology, it is necessary to establish its exact cause in a particular case and try to avoid the influence of this factor or treat a disease that provokes a similar phenomenon.
Complications of this pathology
Consider what threatens the disease? Fistula can cause complications after hemorrhoid surgery. If pus enters the peritoneal cavity, peritonitis can occur, which most often leads to death.
In addition, bleeding may begin, leading to anemia. Stagnant feces can cause intoxication, which will negatively affect the well-being of the patient and the functioning of other organs.
With numerous scars, disturbances in the activity of the sphincter may appear, and because of this, feces will not be retained.
In certain situations, a malignant neoplasm may develop due to a fistula. It is very important to start treating the disease right away. With the timely operation, a person will soon be able to soon return to his usual way of life.
We examined why fistula formation occurs after surgery, and how to properly treat it so that there are no complications.