What is Anal Fistula?
Fistula means an abnormal connection or passageway between organs that do not normally connect.
Most commonly it occurs near the anus. This condition is termed as fistula-in-ano. It occurs when a boil or an abscess develops in anal glands. If the opening of these glands get blocked then the infection gets confined to that area as it is unable to drain out into the rectum. It balloons up to form a pus boil or an abscess and it will keep growing inwards to form a tract. This tract is called fistula whose primary opening in inside the anal canal and secondary opening is in the perinatal skin.
Every time the opening gets blocked an abscess will develop and the tract will increase in size. Sometimes in a chronic case we may see more than one opening and multiple tracts.
It can happen in 10 out of 100,000 population. It is more common in males. It is usually common in people aged between 30 and 50 years.
Causes:
There is usually a history of one of the following:
- Anorectic abscess (most common cause).
- Piles or hemorrhoids.
- Anal fissures.
- Surgery for piles or fissures usually give rise to fistula in future.
- Constipation.
- Crohn’s disease.
- Carcinoma.
- Anal fissures.
- Actinomycosis.
- Chlamydial infections.
- Radiation therapy.
Symptoms:
Anal fistula is mostly present with the following symptoms, when there is infection or strain or block.
- Feeling of lump near the anus with stabbing/throbbing pain
- Pain will shut off immediately after letting out the pus
- Continuous or intermittent (on and off) leakage of foul pus/mucous/fecal matter from the fistula’s external opening, soiling the inner garments
- Discomfort and skin infections due to constant wetness caused by leaked fluids
- Constipation or diarrhea
- If fistula gets blocked, again there will be abscess formation with the symptoms of swelling, fever, malaise and septicemia.
Diagnosis:
Anal fistula can be diagnosed easily by physical examination of the anus and its surroundings. Rectal examination, sigmoidoscopy and fistulography give more details about the abscess, its tracts and openings.
Lab Diagnosis:
- Fistulography.
- Endorectal/endoanal ultrasound.
- MRI.
- CT scan.
- A barium enema/small bowel series to rule out inflammatory bowel disease.
Management:
- Take plenty of water and fruit juices to avoid constipation
- Follow hygienic measures in cleaning and caring
- Pass stool twice a day to avoid strain to rectum and anus
- Don’t strain while defecating. It is better to have semisolid stool for easy defecation
- Sitz bath – After passing stool, sit in a shallow bath tub filled with antiseptic lotions or warm salted water for 10 minutes, to make the condition hygienic.
- Hot compress can help anal abscess by enhancing blood circulation for diluting the infective toxins over there and healing faster with supply of nutrients
Homeopathic Treatment:
The patients of fistula in ano are usually advised surgery for their problem. But this is just a temporary solution as invariably it recurs. Also a lot of complications can occur due to surgery like urinary retention, bleeding, thromboses hemorrhoids, fecal impaction, incontinence of stool, anal stenosis because of fibrosis, delayed wound healing and what not. Invariably patients come to a homeopathy doctor after many years of suffering and sometimes after going through multiple surgeries. Homeopathic medicines will first work to control the infection in the area thereby preventing attacks of the abscess formation. Later, the remedies will start new tissue development to close down the tract. When the process of redeposit is complete the opening closes down and the anorectal fistula is cured permanently. This is a prolonged process and the time required varies from person to person, depending on the length and depth of the tract.
There are 72 remedies in homeopathy. DrAamir’s Specialist Online Homeopathic Clinic choose the best suited remedies for a particular patient by analyzing the case diligently.
For example, Hepar sulphuricum is chosen when the patient complains of a large and extremely painful boil near the anal region. The person has a sense of a splinter. This remedy causes the abscess to open up and the pus drains out. It works like a surgeon’s knife while draining abscesses. The skin is extremely sensitive. We use this remedy with good results.
Sometimes we use Silicea when there is a tendency for the pus to form easily and this does not heal completely. Thus, over a period of time, a fistula in ano develops. The patient has chronic constipation. The rectal muscles do not function properly. The problem alternates with chest complaints. In Silicea the abscess and fistula leave thick scars.
Bacillinum may be used as an inter-current medicine in a case of fistula in ano. It is used when other remedies fail to completely cure the case. This remedy will improve the vitality and clear up the case.
Tuberculinum koch comes to mind for chronic cases where there may be more than one opening of the fistula tract. The healing powers of this patient are very poor. He does not respond to remedies as the homeopath may expect. In such a case one must always think of Tuberculinum. The discharge is thick green and blood streaked.
A fistula usually takes almost 6 month to completely heal. Hence patients should have a lot of patience while on the treatment in order to achieve a complete and permanent cure.
