Understanding Anal Fistula Surgery: What You Need to Know
An anal fistula may be very painful and bothersome and can interfere greatly with the quality of life. Because it is frequently misunderstood or couples can be too embarrassed to even discuss it, it’s important for people to know that it is easily treated and that you don’t have to suffer in silence. The purpose of this blog is to offer our readers a straightforward and factually correct explanation of anal fistula surgery; what causes it; what the symptoms are; and what treatment is available for it, especially for those who are based in the UK and might be considering consulting with or seeking advice on it from a UK medical professional.
What is an Anal Fistula?
An anal fistula is a small tunnel that develops under the skin and connects the end of the bowel and the skin. It’s usually the result of an anal abscess; as pus accumulates in the infected anal gland, it creates the fistula.
Though some fistulas might seem straightforward, most are complex and can split off in various directions. An anal fistula is not likely to heal on its own without treatment, which can result in chronic infection or other complications.
Common Symptoms of an Anal Fistula
Here are some symptoms that you should consult a doctor for:
- Anal pain and swelling
- Greenish, yellow or whitish discharge from the anus
- Itchiness in the skin outside the anus
- Fever and chills (if the infection is generalised)
- Abscesses that keep coming back
These symptoms can vary in intensity and worsen if the original fistula is reinfected. Antifungal therapy should be initiated early in the course of this disease to minimise the risk of complications.
Causes and Risk Factors
Anal fistula is most often a result of previous or untreated anal abscess. Fistulas may be left after an abscess has drained or been surgically treated. Other reasons might be:
- Mucous colitis (another name for IBS)
- Inflammatory bowel disease (Crohn’s disease)
- Trauma or surgical injury
- Tuberculosis
- Radiation treatment
- Cancer (rarely)
While an anal fistula can develop in anyone, it’s more common in men and typically impacts people between the ages of 30 and 50.
Treatment Options: Why Surgery Is Often Necessary
Unlike certain other anorectal diseases, fistulas rarely spontaneously heal with drug therapy. Temporary antibiotics treatment may control the infection; however, surgical treatment is often necessary in order to fully treat the problem and avoid recurrence.
Types of Anal Fistula Surgery:
Fistulotomy
- The procedure most frequently performed, particularly for simpler fistulas. The surgeon lays open the fistula tract, which then heals from inside to outside. It’s usually done under general anaesthesia and works well.
Seton Placement
- A seton (surgical thread) is inserted into the fistula in more complex or high-risk fistulas, so that the tract remains open and can drain; over time, it heals from the inside out.
Advancement Flap Procedure
- Applied when the retention of anal sphincter muscle function is desired. The tract of the fistula is excised and the internal opening within the rectum covered up with a flap of normal tissue.
LIFT Procedure (Ligation of the Intersphincteric Fistula Tract)
- A more recent procedure tying off and cutting out the fistula tract to minimise anal sphincter damage.
The choice depends on the complexity, site, size of the fistula and the overall health of the patient.
Recovery and Aftercare
Anal fistula surgery recovery time depends on the type of surgery performed and the patient’s general health. Most patients can return home the same day or the day after surgery is performed. Key points include:
- Slight pain or discomfort for several days, usually controlled with over-the-counter pain relievers
- Keep your wound clean to avoid infection
- Taking warm baths to alleviate pain and accelerate the healing process
- A diet high in fibre as well as drinking enough water to avoid constipation and not put too much strain during defecation
Complete recovery may require several weeks, with regular check-ups to ensure proper healing.
Risks and Potential Complications
Like any surgery, there are some risks:
- Infection or delayed healing
- Minor bleeding
- In rare cases, incontinence may occur, especially in complex cases
- Recurrence of the fistula
However, anal fistula surgery is usually safe and effective when performed by experienced surgeons. Good aftercare and follow-up greatly decrease the risk of complications.
Final Thoughts: When to Seek Help
If you suspect you may have an anal fistula, don’t delay seeking medical advice. Early diagnosis and treatment can prevent the condition from worsening and improve your overall quality of life.
Suffering from anal fistula symptoms? Schedule a consultation with our experts now to discuss your bespoke treatment plan.
Read more in the NHS guide on anal fistula.
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