What is an anal fistula

An anal fistula is the abnormal communication of the inside of the anus with the skin around the anus, or even with more separate tissues such as the scrotal pouch or the vagina.

What is anal fistula and what are its symptoms?

It is an annoying and potentially disabling disease, which causes the patient pain and continuous discharge of pus. It can also happen that an accumulation can form inside causing an abscess, which requires urgent surgery.

What causes this pathology and is there any way to avoid or prevent it?

The most common cause is inflammation and infection of a small gland inside the anus. It is not known why this happens, so no factors have been found that favor it or allow its prevention. Less frequently, the inflammation is associated with a condition called Crohn’s disease or even in the context of postpartum, as a consequence of a vaginal tear at the time of delivery (recto-vaginal fistula).

Can the fistula lead to another disease?

Exceptionally, fistulas have been found to become malignant after many years of suffering.

How to treat anal fistula?

The complexity of a fistula is defined by the number of openings around the anus, or number of tracts and orifices inside. More importantly, its relationship with the sphincters (muscles that allow continence of stool). Depending on this, simple treatments can be performed, such as removal of the fistula by cutting a little of these muscles, which may have little impact on continence. Or to perform procedures that should avoid damaging them, removing only the path and closing the orifice inside.

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Nowadays, therapies with sealants (such as collagen) or the use of regenerative medicine (growth factors and stem cells) are making a real change in the therapeutic paradigm, since they can cure up to half of the patients with a single injection, without the need for cures. On the other hand, there is no compelling scientific evidence to recommend the use of laser as a treatment for anal fistula.