Fistulas come in various shapes and sizes, with the majority of them being surgically removed.
According to Dr. Dipesh Thacker, who provides an incredible fistula treatment from Bhuj, surgical success rates are high, and most people recover fully. Still, the types of surgery and recovery times vary.
Fistulas are a severe complication of conditions such as Crohn’s disease and some surgeries.
Fistulas can affect a person’s health and well-being significantly. An anal fistula is the most common type of fistula.
Antibiotics and other medications can be used to treat some fistulas. If none of these methods work, surgery to remove the fistula may be required.
In this article, Dr. Dipesh Thacker, who’s among the best ayurvedic surgeon from Bhuj, describes what to anticipate during and following fistula surgery.
What is a fistula?
A fistula is a strange tube-like link between two vessels or organs within the body.
Fistulas are most commonly caused by infection or inflammation due to an injury or surgery.
Fistulas can occur in a variety of locations throughout the body, but the following are the most common:
perianal or Anal or fistulas, which begin between:
- The anus or rectum and vagina
- The anal canal and anal opening
- The vagina and colon
Fistulas in the urinary tract, which originate between:
- The uterus and bladder
- The urethra and the vaginal canal
- Bladder and vaginal canal
Fistulas between the esophagus and the stomach are known as gastrointestinal fistulas.
- two parts of the intestine
- part of the gastrointestinal tract and the skin
- part of the intestine and another organ in the body, such as the bladder
According to Dr. Dipesh Thacker, a leading surgeon specializing in anorectal disorders from Akshar Hospital in Bhuj, Aortoenteric fistulas can develop between the jejunum or duodenum and the native aorta or a prosthetic aortic graft and any part of the GI tract.
Although the other types of fistulas listed above can usually be treated as an outpatient, aortoenteric fistulas are surgical emergencies.
Symptoms
People will have different symptoms depending on where their fistula is located in the body.
Anal fistulas can cause:
- An unpleasant smelling discharge near the anus
- A high temperature, if an abscess is also present
- Passing blood with a bowel movement
- Difficulty controlling bowel movements
- Skin irritation around the anus throbbing pain
- Swelling and redness around the anus
Fistulas in the urinary tract can cause the following symptoms:
- Abdominal pain
- Discharge or urine leaking from the vagina
- Feces leaking into the vagina
- Frequent urinary tract infections
- Unpleasant-smelling gas or discharge from the vagina
- Irritation in the vulva
- Passing gas through the urethra during urination
Symptoms of gastrointestinal fistulas include:
- Abdominal pain
- Diarrhea
- Dehydration
- Fever
- A raised heart rate
- Malnutrition
- Vomiting
Vomiting
Bloody diarrhea or vomit, as well as low blood pressure, are signs of aortoenteric fistulas.
Causes
According to Dr. Dipesh Thacker, the founder of Akshar Hospital in Bhuj, Gujarat, Fistulas usually develop as a result of a bodily injury or inflammation.
Ulcers form due to inflammation, spreading to another part of the body. This includes a channel that aids in the drainage of pus from an infected area.
Fistulas can be caused by a variety of factors, including:
- Crohn’s disease
- Diverticulitis
- Ulcerative colitis
- Hidradenitis suppurativa
- Tuberculosis
- HIV
- Surgery
- Childbirth or obstructed labor
- A history of radiation to the abdomen
- Injury
Anal fistulas are treated surgically.
Antibiotics and other medications may help some fistulas heal, but most require surgery.
Fistulotomy and seton surgery are the two main surgical options for treating an anal fistula.
Fistulotomy is a surgical procedure in which a specialist cuts a fistula along its length and allows it to heal into a flat scar. A surgeon will place a piece of thin surgical thread inside the fistula during seton surgery to help drain any infection and allow it to heal.
Other options for treatment include:
- endoscopic ablation
- LIFT procedure
- advancement flap procedure
- an anal fistula plug to close the fistula and allow it to heal
- medical glue to close the fistula
Each procedure for treating fistulas has its own set of advantages and disadvantages. To be sure of what to expect during surgery, a person should discuss these with their surgical team.
What to Expect Before and After Surgery
Following fistula surgery, most people will not need to stay in the hospital overnight.
Fistulotomy
Anal fistula surgery usually takes about an hour, but patients will need to stay in the hospital for some time before and after to prepare and recover.
If the fistula is small and shallow, the procedure may only require a local anesthetic. Otherwise, a general anesthetic will be used to put them to sleep.
The surgeon will take an incision during the fistulotomy to open up the fistula.
Placement of Seton
This procedure takes about an hour for an anal fistula, but it can take longer depending on how complicated the fistula is. During the process, a person will be sleeping.
Following the seton placement in the fistula, the surgeon will cover it with a light, padded dressing.
A person can usually go home the same day if the surgery is straightforward and without complications.
Seton placement surgery is frequently done in stages by surgical teams, so a person may need additional operations to adjust or replace the seton.
The fistula may continue to drain for several weeks after surgery.
Recovery and follow-up
“The length of time it takes to recover from fistula treatment is determined by the type of procedure and its complexity,” says Dr. Dipesh Thacker, a masterful Ayurvedic specialist from Bhuj.
A person’s surgical team can provide personalized advice on how to recover.
The majority of wounds should heal in six weeks.
The following is general advice for those considering fistula surgery:
- For pain relief, take over-the-counter pain relievers like paracetamol or ibuprofen.
- Wash the wound several times a day to keep it clean. It should be patted dry rather than rubbed.
- The wound dressing should be changed regularly. A nurse should demonstrate this.
- To prevent discharge from leaking onto clothes, place an extra gauze pad over the wound.
- To avoid irritating an unhealed wound, exercise gently. For the initial few weeks following the surgery, avoid sexual activity.
Seek out people who have gone through similar experiences.
Complications and risks
There is a risk of complications with any surgery.
Infection, bleeding, and adverse anesthetic reactions are common complications of fistula surgery.
Specific complications of anal fistula surgery include:
- losing control of one’s bowel
- taking a long time for the wound to heal
- the fistula coming back
- narrowing of the anal canal, making it difficult to have a bowel movement
If a person is in severe pain or has trouble bowel movements, they should see a doctor.
Side effects
According to Dr. Dipesh Thacker, an outstanding Ayurvedic specialist from Bhuj,
A person may experience the following side effects after fistula treatment:
- Nausea
- Cramping
- Diarrhea
- Soreness around the area of the wound
- Constipation
Such side effects should subside after some days as the body starts to recover.
Outlook
A fistula can significantly impact a person’s quality of life.
On the other hand, Fistula surgery is generally successful, with low recurrence rates. A fistulotomy, for example, has a long-term success rate of 92–97 percent.
Summary
Living with a fistula is rarely permanent, with many surgical treatment options available.
The diagnosis, treatment, and recovery from a fistula can be time-consuming and frustrating.
There is, however, a great deal of help available for anyone going through this.
Anyone with a fistula should consult a doctor or healthcare team to determine the best treatment option.
