What Is Anal Abscess And Fistula?

An anal fistula (also known as a fistula-in-ano) is a short tunnel that connects a hole within the anal canal to a hole in the epidermis around the anus. A prior or ongoing anal abscess is a common cause of an anal fistula. A fistula can develop in up to 50% of persons who have an abscess. A fistula can, however, develop without the presence of an abscess.

Causes

Normal anatomy includes small glands immediately inside the anus. An infection can occur if the glands in the anus get blocked. When an infection is severe enough, it might lead to an abscess. Bacteria, excrement, or foreign substances can obstruct the anal glands, resulting in an abscess. Infections and fistulas can be exacerbated by Crohn's disease, cancer, trauma, and radiation.

Symptoms

In the region around the anal area or canal, a patient with an abscess may experience discomfort, redness, or swelling. Feeling sick or exhausted, as well as a fever and chills, are all frequent symptoms. Fistula patients experience comparable symptoms, as well as discharge from a hole near the anus. If these symptoms recur in the same location every few weeks, a fistula is suspected.

Diagnosis

Clinical findings are used to diagnose and treat most anal abscesses or fistulas. Imaging investigations such as ultrasound, CT scan, or MRI may be utilized to see the fistula tunnel and aid in the diagnosis and management of deeper abscesses.

Treatment

In the majority of cases, surgical drainage is used to treat an abscess. It's critical that your surgeon be well-versed in the treatment of abscesses and fistulas. In this field, colorectal surgeons are specialists. An abscess may usually be drained surgically with a simple treatment for the majority of patients. To drain the infection, an incision is made in the skin around the anus. This can be done under local anaesthetic in your surgeon's office or under general anesthesia in an operating room. Some people with more severe condition may need numerous procedures to resolve the issue. Patients with diabetes or immune system disorders who are prone to more serious infections may need to be admitted to the hospital.

An anal fistula almost invariably necessitates surgery. A fistulotomy is performed in many people if the fistula is not too deep. The fistula track will be opened during this procedure to allow for healing from the bottom up. A tiny piece of the sphincter muscle may need to be divided during surgery. A major portion of the sphincter muscle is not split, which might cause bowel control issues (fecal incontinence). If a considerable amount of the sphincter muscle is implicated in the fistula track, other, more complex operations are performed to repair the fistula without hurting the sphincter muscle. Multiple procedures may be required in more challenging instances.

Abscesses and fistulas cannot be treated with antibiotics alone. If a patient has immune concerns, certain heart valve disorders, or extensive cellulitis, antibiotics may be required in addition to surgery (a bacterial infection of the skin and tissues under the skin). Giving your doctor a complete medical history and having a physical exam are key stages in determining whether antibiotics are needed.

Prognosis After Treatment

Your surgeon will instruct you on how to care for yourself after surgery. Unfortunately, an abscess or a fistula can recur even after thorough treatment and complete recovery. If an abscess returns, it's possible that there's a fistula that has to be addressed. If a fistula recurs, more surgery will almost certainly be necessary to resolve the issue.