Fistula is a medical term that is used to describe an abnormal connection between two hollow spaces in the human body. Most of these spaces are epithelized surfaces and it includes blood vessels, intestines and other hollow organs present in the body. Fistulas are most commonly caused by injury, infection or inflammation. In some cases, fistulas are induced by surgeries.
Broadly speaking, the most common type of fistulas are:
- Anal fistula
- Obstetric fistula
- Arteriovenous fistula.
Anal Fistula: A Brief Overview
An anal fistula is an infectious tunnel formed between the anus and the external skin. It is a chronic condition where there is an abnormal communication between the perianal skin and epithelialized skin around the anal canal. It is also known as fistula-in-ano.
The anus is the external opening in a human body through which the digestive system expels out faeces. There are few glands just inside the anus, which may get infected due to exposure to pathogens or blockage. This leads to formation of an infected cavity which is also known as abscess. 50 percent of these abscesses may progress into fistula; where there is communication between the infected glands and external skin through an infected tunnel called as fistula. Anal fistula is generally associated with pain, swelling and discomfort over the anal area along with painful bowel movements, abnormal discharges and generalized discomfort and irritation.
How Long does it Take a Fistula to Heal?
Once the anal fistula has been diagnosed, a treatment modality is planned by a colon and rectal specialist. Treatment generally involves surgery based on the depth, extent and severity of the fistula. Most of the anal fistulas respond well to surgery and heal within 1 – 6 weeks post-surgery, depending on the severity of the condition. Fistulotomy is a common surgical procedure that is done for management of anal fistula. In this process, the skin and the muscles over the infected tunnel are cut open, which allows healing of the anal fistula from inside out. In severe cases, it may be required to place a special drain called as a seton for adequate drainage. This drain is usually placed for about 6 weeks, after which surgical repair is carried out. Most of these surgeries are carried out on an out-patient basis, and in cases of large and deep fistula, a short hospital stay may be required to accelerate healing of anal fistula.
Most of the patients are able to go back to work after 1 to 2 weeks after surgery for anal fistula. For some cases, it takes about 6 weeks for complete healing of anal fistula. However, for some it may take from few weeks to several months and sometimes even years for complete healing of the fistula. It is advised to follow up with the surgeons on a regular basis as recommended during the healing phase for monitoring and evaluating the healing process and early detection of reoccurrence. Most of the surgeons recommend placement of gauze over the surgical site for absorbing drainage; and soaking the area in warm bath for providing relief, prevent infection, faster recovery and complete healing of anal fistula. It is also recommended to take stool softener and laxatives for a week, as the area is sore after surgery. Pain killers are often recommended for management of pain over the area.
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