To better understand what a perianal fistula is, it is first important to know what a fistula itself is. A fistula is an abnormal connection that exists between two parts of the body. In this case, this fistula could be the connection that exists between two different organs, two blood vessels, etc…
Now, taking into account what is a fistula and what the perianal fistulas are, is that connection that exists between an external hole that is in the skin of the anus and an internal hole, which is inside it.
When a perianal fistula problem occurs, it is because one of the duct glands becomes infected and therefore an abscess is produced, which would be a cavity filled with pus. These abscesses must be drained surgically, although some of them may be drained spontaneously. If they do not drain properly, they will end up developing what we know as perianal or anal fistula.
As it is an area of the body that is quite complicated to examine, one of the most accurate ways we have to know that we have a perianal fistula is to know the symptoms it manifests.
The main symptom is a pain in the perianal area. If we have a strong condition in that part, it is important that we visit the doctor because we probably have a perianal fistula problem. On the other hand, and to reinforce this hypothesis, in addition to the pain that occurs, it is common that there is a discharge of pus or any other type of drainage that causes an unpleasant odor.
One of the main problems that usually happen in this sense is that many times the patient does not go to the doctor’s office because he is usually embarrassed to present this type of problem. This shames is accompanied by the fact that many times these pains that occur are not frequent, but occasionally occur, therefore, end up enduring during those days that are worse. Needless to say, this is a serious mistake and besides, of course, the problem is not going to heal on its own, it’s going to get worse.
A perianal fistula can occur in several ways. First of all, the most usual thing is that it occurs due to the likely to occur due to obstruction of a gland, but it is also possible that it occurs due to an injury in surgery or an infection in the area.
Regardless of the reason why the problem has happened, the obstruction should be emptied as soon as possible through surgery, because if it is not done in time, there is a risk that the abscess will continue to increase. That comes to cross the muscle, trying to reach the outside or another exit point, such as the vagina. In all cases, the more time we spend with the problem, the worse it will be.
It may be unpleasant or discouraging, but unfortunately, to this day, there is no non- surgical treatment to end perianal fistula. In this case, medications can help us to treat some of the symptoms that are typical of these fistulas, such as pains, but the only thing they will do is delay waiting for the inevitable.
The interventions that exist are varied, depending on the size of the fistula or the problem in question. Regardless of the treatment, the surgeon will make sure that there is no infection prior to the intervention, so it is likely that antibiotics are administered before the intervention.
Depending on the fistula, we can carry out a fistulotomy, an intervention carried out with regional anesthesia where the skin and part of the sphincter muscle will be cut, flattening the fistula’s own trajectory so that it can heal from within.
On the other hand, if the fistula is more complex, a fistulectomy may be performed. In this intervention, the repair of the sphincters will be carried out by placing grafts in the area and, depending on the patient’s situation; it is possible that an artificial anus will have to be installed. In the case of a fistulectomy, the wound will be larger and also the healing will be slower.