Perianal fistulas are abnormal tunnels between the skin around the anus and the rectum or anus. They usually occur as a result of infections in the anal glands. These infections create a drainage tract, leading to a fistula. Perianal fistulas are characterized by severe pain, swelling, purulent discharge, and recurrent infections. If left untreated, they can become chronic and reduce the quality of life.
Perianal Fistulas Symptoms
They are abnormal tunnels that form around the anus or the lower part of the rectum and usually open from the skin towards the anus or rectum. This condition develops as a result of infections around the anus and over time forms an abscess.
1. Pain and Discomfort: One of the most obvious symptoms is constant pain and discomfort. This pain can be especially worse when sitting, defecating or doing physical activity. The pain is usually concentrated around the anal area.
2. Skin Irritation and Swelling: During fistula formation, a swelling may be noticed around the anus. This swelling may be an indication of an abscess and can be felt by hand. Over time, the swelling may turn into a pus-filled structure.
3. Pus and Discharge: Perianal fistulas often become infected. Purulent discharge may occur as a result of this infection. The pus that can flow out of the hole around the anus has an unpleasant odor. It can cause a constant feeling of discharge.
4. Bleeding: In some cases, light bleeding may occur during defecation or due to pressure around the anus. This bleeding is usually mild and may be accompanied by irritation around the anus.
5. Itching and Irritation on the Skin: Due to the discharge, there is constant moisture around the anus, which can cause itching and irritation on the skin. This irritation on the skin can be an indication of infection and can worsen if left untreated.
It is important for individuals experiencing these symptoms to see a doctor without delay. Early diagnosis and treatment prevents the progression of the fistula and more serious complications.
Perianal Fistulas Causes
Perianal fistulas are health problems that manifest themselves with the formation of an abnormal tunnel around the anus and rectum. These fistulas usually develop as a result of infections. If left untreated, they can lead to serious complications. Different causes play a role in the formation of perianal fistulas. Here is a detailed explanation of these causes:
Anal Abscesses: This is one of the most common causes of perianal fistulas. When the glands in the anal area become infected, abscesses can develop. These abscesses are pus-filled, swollen, and painful formations. Over time, abscesses can tunnel to the skin surface or the intestinal tract, which is called a tunnel fistula. Fistulas usually form during a process where abscesses try to drain on their own.
Crohn's disease is a chronic inflammatory bowel disease that affects the digestive system. This disease causes severe inflammation in the inner lining of the intestine, which can lead to perianal fistulas. Fistulas are common in people with Crohn's disease because the healing process of inflamed tissues is impaired, causing fistulas to develop.
Trauma: Trauma around the anus can contribute to the formation of a perianal fistula. Events such as surgery, injury, or difficult childbirth can cause tissue damage and lead to fistula formation.
Chronic infections such as tuberculosis can also lead to fistula development. These types of infections can cause inflammation in various parts of the body. The risk of fistula increases, especially when the immune system is weakened. HIV and other diseases that suppress the immune system can also trigger fistula development.
Individuals with weakened immune systems are more susceptible to infections, which increases the risk of fistula formation. Diabetes, chemotherapy, or long-term steroid use increase the susceptibility to infections, which can increase the risk of perianal fistula.
Perianal Fistula Treatment
Perianal fistulas are conditions characterized by the formation of an abnormal tunnel around the anus. If left untreated, they can lead to serious complications. They can also negatively affect quality of life. Treatment for perianal fistulas may vary depending on the type of fistula, its location, and the patient's general health.
The most common and effective method for treating perianal fistulas is surgery. Different surgical techniques can be applied to ensure healing of the fistula channels.
Fistulotomy: This is the most common surgical procedure. It is performed by opening the fistula along its entire length and allowing it to heal. Fistulotomy is usually quite effective for simple fistulas and has a low risk of recurrence.
Seton Application: A thin rope is placed around the fistula canal to allow the fistula to heal slowly. This method is preferred in more complex fistulas that aim to protect the anal sphincter muscle. Seton helps to clean the fistula canal of infections.
LIFT (Ligation): This method is a modern surgical technique preferred for more complex fistulas. It is applied to treat the fistula without damaging the muscle structure. The healing process may be faster than other surgical methods.
Fibrin Glue and Fistula Plug: As an alternative to surgical intervention, fibrin glue and biological fistula plugs are used. Fibrin glue is injected into the fistula channel to close this channel and ensure healing. Fistula plugs help to close the fistula with special plugs made of biological materials. However, the success rate of these methods is lower compared to surgical methods.
Medication: In some cases, medications that suppress the immune system may be used. These medications can help stop the development of a fistula or help shrink an existing fistula. However, medication is generally not a substitute for surgery. It is more often used as a supportive measure.
Diet and lifestyle changes are important in fistula treatment to speed up the healing process. Adequate fiber intake, plenty of water consumption and hygiene are beneficial.
Perianal fistula treatment is individualized according to the patient's condition and the characteristics of the fistula. With appropriate treatment, fistulas can usually be treated successfully. However, the risk of recurrence must also be considered.
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