Fistula is a small tunnel that develops between the end of the bowel and skin around the anal area. It is formed due to infected glands that create the abscess.

Causes of Anal Fistula

• The main cause of fistula is an infection of anal glands. This infection leads to anal abscess or pus. If this abscess fails to heal with or without treatment then it results in a fistula.

• Conditions causing inflammation such as chron’s diseases.

• Infection due to Tuberculosis, HIV and sexually transmitted diseases.

• Due to the complication of previous surgery in the anal region.

Symptoms of Fistula

• Severe pain while sitting.
• Swelling, itching near the anal region.
• Discharge of pus or blood which is of foul smell.
• Pain during bowel movements.
• Fever.

Treatment Methods for Fistula

There are various treatment options available for fistula. The conventional treatment methods include Fistulectomy and Ksharsutra. The recent treatment methods include FiLac (Fistula Tract Laser Closure), VAAFT (Video Assisted Anal Fistula Treatment) and DLPL (Distal Ligation Proximal Laser).

Fistulectomy: This procedure is performed under general anesthesia and fistula tract is completely excised. In this, there is a risk of damage to the sphincter muscle which results in fecal incontinence.

Ksharsutra: This is an ancient ayurvedic treatment in which the fistula tract is coated with Ayurvedic preparations and is inserted into the fistula tract. As all pus is drained, healing begins in a clean environment. The advantage of this method is it is minimally invasive as there are no cuts and stitches. Also, there is no damage to the sphincter muscle and success rate is also fairly good.

The main drawback of this procedure is that it requires multiple weekly sessions over months and is less effective for recurrent and complex fistula cases.

VAAFT (Video Assisted Anal Fistula Treatment): This technique is used for complex fistula cases. There are no surgical wounds on the buttocks and no damage to sphincter muscle but the recurrence rate is 30%.

FiLac: This procedure is performed using Leonardo laser. It was first introduced in India at Healing Hands Clinic. The main advantage of this method is that there is no damage to the sphincter muscle.

DLPL (Distal Laser Proximal Ligation): Fistula is a complex disease and aims for fistula treatment is not only to get rid of existing fistula but also to save sphincter muscle and to prevent recurrence of the disease.

DLPL technique is Dr. Ashwin Porwal’s own innovation and in his series of 100 patients with complex fistula treated with DLPL, there was not a single case of recurrence or incontinence.

Till date, more than 10,000 patients suffering from fistula have been successfully treated at Healing Hands Clinic. HHC is a certified center of excellence for the treatment of fistula having centers at Pune, Mumbai, Thane, Navi Mumbai, Baner, Chakan, Chinchwad, Kothrud, Nashik and Bengaluru. Dr. Raj Gautam is the leading surgeon for treatment of anorectal disorders such as Piles, Fissure, Fistula, Constipation, Pilonidal Sinus and others at healing Hands Clinic Thane. He has 15 years of experience in the medical field.

Author's Bio: 

Proctologist at Healing Hands Clinic