What is meant by an anal fistula? An anal fistula is short for anorectal fistula, also known as hemorrhoid fistula or fistula in Chinese medicine. Why is it called a fistula? It is because the main symptom is the repeated flow of pus or blood from the sores on the skin around the anus, or even the flow of feces, like a broken house often leaking water, so our ancestors named it fistula. The fistula is a common disease in the anorectal department and can occur in both men and women, but the majority of patients are young adults, and from medical statistics, men account for the majority of fistula patients, which is the opposite of fissure patients, why is this so? It is not clear why women have fewer anal fistulas. However, it is thought that perhaps it is because men have a larger and deeper anal fossa than women, which makes it easier for bacteria to invade; or that it is related to the high secretion of the sebaceous glands, one of the sex hormone target organs in men; or that men have a strong anal sphincter and greater pressure in the rectum, which easily presses bacteria into the fossa. Anorectal fistulas, which mainly invade the anal canal and rarely involve the rectum, are granulomatous canals around the anus that consist of an internal, fistula, and external opening. The internal port is often located in the lower rectum or anal canal and is mostly one; the external port is on the perianal skin and can be one or more, and is persistent or intermittently recurrent, and is one of the common rectal-anal diseases, second only to hemorrhoids in incidence. Formation of anal fistula An anal fistula can be said to be a sequel to a perianal abscess. The line dividing the rectum from the anus is called the dentate line and is wavy. The depressed part of it is called the anal fossa or anal fossa. Further in is called the anal gland, which is similar to the sweat gland that excretes sweat and the sebaceous gland that excretes fat. Occasionally, these bacteria invade the anal glands from the anal fossa and cause infection and pus when the body’s resistance is reduced. Through such suppuration, pus is stored in large quantities around the anus, forming a perianal rectal abscess. The disease is very painful, with throbbing pain, painful sleep, and general or localized fever. Perianal abscesses naturally penetrate the skin and flow out pus if left unattended, but on most occasions the pain is so unbearable that an incision is required to drain the pus. In this way, although it is temporarily comfortable, it does not mean that the disease is cured. The anal fossa and the anal glands that have been invaded once by bacteria are not closed and are open forever. As a result, bacteria continue to enter and pus is formed inside and flows out. This forms a pus duct from the anal fossa to the perianal area, which is called an anal fistula. Therefore, it can be said that anal fistula is the sequelae of perianorectal abscess. In addition, anal fistula can be secondary to or complicated by anorectal trauma or injury to the rectum due to accidental swallowing of foreign objects such as date palm, chicken, duck and fish bones, or repeated infection of anal fissure, or systemic diseases such as diabetes, tuberculosis and Crohn’s disease. The treatment of anal fistula Patients with anal diseases often have a tendency to feel unnecessarily shy about their disease, which is useless, especially if the anal fistula is not operated on, it cannot be cured, and surgery is the only cure for anal fistula. The only way to cure an anal fistula is through surgery. You should abandon the psychological state of being shy or afraid of pain and seek out an anorectal specialist early to remove the fistula from the fossa to the fistula. As the severity of fistula varies, so does the type of surgery. The surgical approach must be tailored to the specific case of the fistula. However, there is a pattern to the course of the fistula, with most fistulas with an external opening within 5 cm of the anal verge having an internal opening inside the corresponding anus, and slightly more complex fistulas with the primary focus almost directly behind, the most common of which is the horseshoe fistula. The initial fistula is still unbranched and not only can the operation be easily completed, but also the function of the anus can be quickly restored to normal. A simple low anal fistula can be treated painlessly without hospitalization under local anesthesia, but the surgery requires removal of the entire fistula and scar tissue containing the anal fossa in order to prevent recurrence, so complete healing time is longer, usually about a month. If the fistula is left untreated, some lesions may move to the perirectal area and between the sphincter muscles, and the fistula may spread deeply and widely. It is best to be hospitalized for this level of fistula because the treatment of the wound after surgery is also very important and is one of the reasons for the high recurrence rate of fistulas. When the fistula penetrates above the full length of the external anal sphincter, surgery by incision and dilation is considered to be the best and safest method, requiring a certain level of experience and skill. The surgery should be performed to minimize the damage to the anal sphincter in order to protect the anal sphincter function as much as possible and to avoid the sequelae of anal incontinence. The most important thing to note about anal fistula prevention is that it is particularly important. How can anal fistula be prevented? The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The actual fact is that you should eat more light foods that are rich in vitamins, such as green beans, radish, winter melon and other fresh vegetables and fruits. The most important thing is to have a good understanding of the situation. 2, a good defecation habit: daily after defecation sitz bath to keep the anus clean, to prevent infection has a positive effect. 3, anal burning discomfort, anal drop, to find out the cause and timely treatment. 4.Prevent constipation and diarrhea: It is important to prevent perianal rectal abscess because dry stool can easily bruise the anal sinus, plus infection by bacterial invasion. Most people with diarrhea have the presence of proctitis and anal sinusitis, which can lead to further development of inflammation. 5, inspection should be gentle: in the anal routine inspection, be gentle, avoid violence, so as not to damage the anus. To do this, patients are required to go to regular professional hospitals for routine anal examinations. 6, it is advisable to treat other anal diseases as early as possible: such as ulcerative colitis, anal sinusitis, anal papillitis patients, must go to a regular professional hospital for treatment as early as possible, so as not to cause perianal rectal abscess and anal fistula due to infection.