How is fistula diagnosed

Filling the fistula with a special glue or plug. This is a newer type of treatment that closes the inner opening of the fistula. The doctor then fills the fistula tunnel with a material that your body will absorb over time. Reconstructive surgery or surgery that is done in stages. This may be an option in some cases. Seton placement. This procedure involves placing a suture or rubber band seton in the fistula that is progressively tightened.

It lets the fistula heal behind the seton and reduces the risk of incontinence. For those with both Crohn's disease and a fistula, medical therapy is often tried before surgery. Complications include a fistula that recurs after treatment and an inability to control bowel movements fecal incontinence.

This is most likely if some of the muscle around the anal opening, called the anal sphincter, is removed. Call your healthcare provider if you have symptoms of an anal fistula, especially if you have a history of a previous anal abscess. If you have been treated for an abscess or fistula, let your provider know right away if you have any of the following:.

When recovering from anal fistula treatment, make sure to take pain medicine as directed by your surgeon. Finish all of your antibiotics. Health Home Conditions and Diseases. Actively scan device characteristics for identification. Use precise geolocation data. Select personalised content. Create a personalised content profile. Measure ad performance. Select basic ads. Create a personalised ads profile. Select personalised ads. Apply market research to generate audience insights. Measure content performance.

Develop and improve products. List of Partners vendors. A fistula is defined as an abnormal connection of two body cavities such as the rectum and the vagina , or as the connection of a body cavity to the skin such as the rectum to the skin.

One way a fistula may form is from an abscess —a pocket of pus in the body. The abscess may be constantly filling with body fluids such as stool or urine, which prevents healing. Eventually, it breaks through to the skin, another body cavity, or an organ, creating a fistula.

Fistulas are more common in Crohn's disease than they are in ulcerative colitis. Fistulas are typically treated with surgery or with wound care. Fistulas often occur in the area around the genitals and anus known as the perineum. Symptoms of fistulas can include pain, fever, tenderness, itching, and generally feeling poorly.

The fistula may also drain pus or a foul-smelling discharge. These symptoms vary based on the severity and location of the fistula. Fistulas are usually diagnosed through the use of a physical exam, a computed tomography CT scan, and, if needed, other tests such as a barium enema, colonoscopy , sigmoidoscopy , upper endoscopy , or fistulogram.

During a fistulogram, a dye is injected into the fistula, and X-rays are taken. The dye helps the fistula to show up better on the X-rays. The dye is inserted into the rectum, similar to an enema , for fistulas that are in the rectum.

The dye must be 'held' inside during the procedure. With a fistula that opens to the outside of the body, the dye is put into the opening with a small tube. X-rays will be taken from several different angles, so a patient may have to change positions on the X-ray table. As with any other kind of X-ray, remaining still is important. When it's suspected that a patient has an enterovesicular bladder fistula, an intravenous pyelogram IVP , another type of X-ray, may be performed. Prepping for this test may include a clear liquid diet or fasting because stool in the colon can obstruct the view of the bladder.

The dye contrast material is injected into the arm, and several X-rays are taken. A fistula may cause complications. In some cases, fistulas might not heal and become chronic. Other potential complications include fecal incontinence, sepsis , perforation , and peritonitis.

Sepsis is a life-threatening illness that results from the body's response to a bacterial infection.

Peritonitis is an inflammation or infection of the peritoneum, the tissue on the abdominal's inner wall that covers the abdominal organs. Treatments for fistulas vary depending on their location and severity of symptoms. Medical treatments include Flagyl an antibiotic , 6-MP an immunosuppressant , or certain biologic therapies including Remicade and Humira.

An enteral diet may be prescribed for enterovaginal, enterocutaneous, and enterovesicular fistulas. Surgery is recommended in most cases. Symptoms of an anal fistula Symptoms of an anal fistula can include: skin irritation around the anus a constant, throbbing pain that may be worse when you sit down, move around, poo or cough smelly discharge from near your anus passing pus or blood when you poo swelling and redness around your anus and a high temperature fever if you also have an abscess difficulty controlling bowel movements bowel incontinence in some cases The end of the fistula might be visible as a hole in the skin near your anus, although this may be difficult for you to see yourself.

When to get medical advice See a GP if you have persistent symptoms of an anal fistula. These may include: a further physical and rectal examination a proctoscopy, where a special telescope with a light on the end is used to look inside your anus an ultrasound scan , MRI scan or CT scan Causes of anal fistulas Most anal fistulas develop after an anal abscess.

Less common causes of anal fistulas include: Crohn's disease — a long-term condition in which the digestive system becomes inflamed diverticulitis — infection of the small pouches that can stick out of the side of the large intestine colon hidradenitis suppurativa — a long-term skin condition that causes abscesses and scarring infection with tuberculosis TB or HIV a complication of surgery near the anus Treatments for an anal fistula Anal fistulas usually require surgery as they rarely heal if left untreated.

The main options include: a fistulotomy — a procedure that involves cutting open the whole length of the fistula so it heals into a flat scar seton procedures — where a piece of surgical thread called a seton is placed in the fistula and left there for several weeks to help it heal before a further procedure is carried out to treat it All the procedures have different benefits and risks.

You can discuss this with the surgeon.