Fistula is an abnormal passage between two organs that are tubular or from an organ to the surface of the body. Some may be surgically created while others may result from infection, injury, or due to a congenital defect.
• AgeOccur at any time during adult life.
Symptoms:
• Watery or purulent discharge from the external opening of the fistula
• Pain is episodic as the fistula fills with pus. If the pus doesn’t discharge
• Pain is more intense and throbbing
• The discharge causes pruritus ani
• There may be minor bleeding from the external opening
• The symptoms in general are episodic but the condition hardly ever cures itself
• History of a peri anal abscess.
• Watery or purulent discharge from the external opening of fistula
• Blubbing on defecation, as mucus is forced through the fistula as the anal canal is stretched over the stool.
• Recurrent episodes of pain.
• Pruritus ani (peri anal skin wet and macerated due to discharge)
Types of Fistula in ano
1. Low level ( anal) – Normal fistulectomy may be compatible with AyurvedicKsharutra.
The internal opening is below the anorectal ring.
They could be of the following:
• Trans sphincter
• Inter sphincter
• Subcutaneous of sub mucous
2. High Level( anal) – Modern Fistulectomy has always a danger of complication like incontinence of Faces. So AyurvedicKsharsutra is better option
The internal opening is above the anorectal ring.
They could be of the following:
• Extra sphincteric (pelvirectalsupralevator)
• Trans sphincteric
• Inter sphinteric
Causes of Fistula in ano
• Sequel of Ano rectal abscess
• Tuberculosis
• Ulcerative colitis – develop regional proctitis
• Cancer of Rectum or Anal Canal
• Lymphogranulomavenerum
• H/O – Ano Rectal or Gynaec Surgery
More Causes of Fistula
• Overweight
• Heavy, cheesy, Greasy Diet
• Indigestion
• Suppression of natural urges
• Alcohol Consumption
• Local injury
• Unhygienic condition
• Straining
• Excessive coitus
• Severe Chronic Constipation
• Bicycle/Horse riding
• Use of jet pipe after defecation, leading to fissure and then to fistula
• Complication to Piles and Fissure
• Infection of the anal glands
• Worm infestation
• Ingestion of foreign bodies
Complex Fistulas.
• Any fistula involving more than 30 percent of the external sphincter
• Suprasphincteric fistulas
• Extrasphincteric or high fistulas, proximal to the dentate or pectinate line
• Women with anterior fistulas
• Fistulas with multiple tracts
• Recurrent fistulas
• Fistulas related to inflammatory bowel disease
• Fistulas related to infectious diseases including tuberculosis and human immunodeficiency virus
• Fistulas secondary to local radiation treatments
• Patients with a history of anal incontinence
• Rectovaginal fistula
Treatment Available;
• MIFT & VAAFT technique
• Kasharsutra
Issued in public Interest
