Anal Fistula Surgery in Dubai
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Ano-Proctology
The anorectal area is a complex system responsible for waste elimination. Discussing matters concerning this area may feel uncomfortable, yet grasping their significance is vital for upholding overall well-being.
Anal fistula is one such condition that can cause significant discomfort and requires medical attention. This Webpage delves into the world of anal fistula, exploring its causes, symptoms, and available treatment options.
What is an Anal Fistula?
An anal fistula arises as an abnormal channel linking the inner part of the anus to the outer skin. It commonly occurs near the upper portion of the anus, close to the anal glands. The formation of a fistula is often triggered by infection in these glands, resulting in drainage and the formation of an abnormal tract.
This infection, called a perianal abscess, frequently precedes the development of the fistula. Occasionally termed as a perianal fistula, the term “perianal” refers to the region surrounding the anus.
What are Anal Fistula symptoms?
Anal Fistula Symptoms include:
- Intense, throbbing anal pain exacerbated by bowel movements, coughing, or sitting. Butt sensitivity to touch is standard.
- Swelling and redness around or inside the anus indicate active infection (cellulitis).
- Fluid drainage near the anus, possibly containing pus, faeces, or blood, often accompanied by a foul odour.
- Fever
- Pain during urination.
- Difficulty controlling bowel movements.
What causes an Anal Fistula?
Certainly, here’s a more concise version:
Common Cause:
- Perianal Abscess: Typically arises from an infected anal gland, forming a pus-filled pocket. The abscess may naturally create a drainage channel or require one to be made by a healthcare provider. If the wound doesn’t fully heal, it can result in a fistula.
Uncommon Causes:
- Inflammatory bowel diseases (e.g., Crohn’s disease).
- Anal STI’s (Sexually Transmitted Infections).
- Tuberculosis in the anal region.
- Traumatic injury or previous anal surgery.
- Radiation therapy for pelvic cancer.
- Actinomycosis, a rare bacterial infection causing abscesses.
- Hidradenitis suppurativa, a chronic skin disease causing abscesses in sweat glands, including the perianal area.
Diagnosis
Diagnosis of an Anal Fistula include:
1. Initial Assessment:
- Symptom discussion and physical exam.
- Examination of the area around and inside the anus.
2. External and Internal Openings:
- External opening is usually visible around the anus.
- Identifying the internal opening inside the anal canal is more complex.
3. Imaging Tests:
- MRI: Maps the fistula tunnel and provides detailed images of pelvic floor structures.
- Endoscopic Ultrasound: Uses high-frequency sound waves to identify the fistula and surrounding tissues.
- Fistulography: X-ray with injected contrast to visualise the fistula tunnel.
- Examination Under anaesthesia: Allows for a thorough examination of the fistula and potential complications.
3. Additional Methods:
- Fistula Probe: Special instrument to trace the fistula tunnel.
- Anoscope: Small endoscope for viewing the anal canal.
- Flexible Sigmoidoscopy/Colonoscopy: Endoscopic procedures to examine the colon; important for identifying related disorders (e.g., ulcerative colitis, Crohn’s disease).
- Injected Dye Solution: Helps locate the fistula opening.
Anal Fistula Treatment in Dubai
Managing an anal fistula hinges on various factors like its location, complexity, and underlying cause. The primary objectives revolve around fully healing the fistula to prevent its return and safeguarding the sphincter muscles.
Preserving these muscles is crucial as their impairment can result in faecal incontinence. While surgical intervention is typically necessary, non-surgical approaches might be considered viable alternatives in some instances.
Treatment Options for Anal Fistula include:
Anal Fistula Surgery in Dubai
1. Fistulotomy
- The procedure involves cutting the fistula’s internal opening, removing infected tissue, and flattening the tunnel.
- Complex cases may require the removal of part of the tunnel.
- A two-stage approach is possible if extensive muscle cutting or complete tunnel identification is needed.
2. Endorectal Advancement Flap
- The surgeon forms a flap from the rectal wall to conceal the internal opening of the fistula.
- Reduces the number of sphincter muscle cuts during the procedure.
3. Ligation of Intersphincteric Fistula Tract (LIFT)
- Two-stage treatment for complex or deep fistulas.
- Preserves sphincter muscles by accessing the fistula between them.
- Utilises a seton to widen the tunnel initially, followed by tissue removal and closure of the internal opening.
Non-Surgical Alternatives
1. Seton Placement
- Involves placing a seton to facilitate drainage and healing of the fistula.
- Can be combined with surgical approaches.
2. Fibrin Glue and Collagen Plug
- Clearing of the tunnel and closure of the internal opening.
- Injection of fibrin glue or inserting a collagen plug through the external opening to seal the fistula.
2. Medication
- Used when Crohn’s disease is implicated as the underlying cause.
- Injection of fibrin glue or inserting a collagen plug through the external opening to seal the fistula.
Advanced Surgical Procedures for Complex Cases
1. Ostomy and Stoma
- Temporary diversion of intestines away from the anal canal to aid healing.
- Waste collection through an abdominal bag.
2. Muscle Flap
- Utilises healthy muscle tissue from alternate body areas to fill the fistula tunnel in complex cases.
Anal Fistula Recovery
Recovery from anal fistula surgery typically involves:
- Outpatient procedure: Most surgeries allow you to return home the same day.
- Pain management: You’ll be prescribed pain medication to manage discomfort. Fibre supplements help prevent constipation, mainly due to pain medication, and should be taken with plenty of water.
- Sitz bath: Soaking your anus in warm water (sitz bath) at least once a day can soothe the area and aid healing.
- Wound care: Dressings may be needed to collect drainage and maintain cleanliness; they should be changed regularly.
Contact Dr Ashok Bohra for Anal Fistula Treatment in Dubai
Dr Ashok Bohra, boasting over two decades of experience, is a widely esteemed gastrointestinal and bariatric surgeon renowned for his dedication to excellence and providing top-notch patient care.
Specialising in minimally invasive techniques, he offers a range of treatments, including upper GI surgeries, hernia repair, and haemorrhoid treatment. Dr Ashok Bohra also performs bariatric procedures for weight loss. Trusted for his expertise and successful outcomes, he addresses diverse patient needs in Dubai.
