I. What is an anal fistula.
The full name of anal fistula is anorectal fistula, also known as anal leakage in Chinese medicine. It is an infected tube formed by the rectum, anal canal and the skin around the anus.
The word “fistula” means a fracture in the body that is caused by a lesion and breaks outward. An anal fistula is a fistula formed when the soft tissue around the anorectum becomes infected with pus and collapses outward or is artificially cut open, starting with one fistula, but as the disease progresses, there can be more than one. The inner mouth of the canal is the entrance to the infection, and more than 90% of them are located in the anal sinus at about 100px from the anal opening. The external mouth of the canal is the ulcerated mouth or surgical incision, mostly outside the anus, but rarely also inside the anus and rectal wall.
Second, the manifestations of anal fistula.
All anal fistulas are accompanied by a history of paranal swelling and painful ulceration and flow of pus of varying degrees. After the formation of an anal fistula, this paranal swelling and painful flow of pus will recur from time to time, and if the pus flows poorly, the local and systemic symptoms of acute purulent infection will be manifested, such as local redness, swelling and pain in the anus and elevated systemic temperature, but these symptoms will gradually decrease as the pus breaks out again.
Another clinical manifestation of anal fistula is the presence of hard masses in the anal area. In addition, long-term pus irritation can lead to perianal dermatitis or eczema, causing itching in the anus.
If an anal fistula is not healed for a long time, it will also cause defecation difficulties, anemia, body wasting, mental depression and neurological weakness.
Third, the formation of anal fistula.
Anal fistula is a late lesion of perianorectal infection, and the main reason for the formation of perianorectal infection (abscess) is caused by various factors that lead to a decrease in the body’s resistance.
The reasons why perianorectal abscesses do not heal themselves and form anal fistulas after ulceration are generally considered to be the following.
1, perianorectal abscess breaks or incisions are mostly outside the anus, and pus flows from the external mouth, but the primary infection is mostly in the anal sinus. The anal sinus is the gateway to continue the infection, because the anal sinus opens upward and opens in the rectal cavity, bacteria and intestinal contents can enter the pus cavity through the anal sinus, causing repeated infections and forming fistulae.
2, the fistula passage between the anal sphincter, because the sphincter often constantly contract and diastolic, affecting the discharge of pus, easy to store pus infection and difficult to heal.
3, after the abscess breaks down, the pus is discharged, the pus cavity gradually shrinks, and the cavity wall forms a hard wall of connective tissue hyperplasia, which cannot heal.
4, the fistula is bent, or has branches, poor drainage, repeated infection, resulting in fistula does not heal.
Fourth, surgery is the only way to finally resolve anal fistulae.
Like paranal abscesses, anal fistulas differ from infections in other parts of the body in that they occur near the anorectum, there is a fixed source of infection in the anal or rectal cavity, i.e., the internal opening, and the lesion is located within the anal sphincter, and the diastole and contraction of the sphincter affect the drainage of pus. Therefore, there is no possibility of self-healing of anal fistula and paranal abscess once they occur, regardless of their severity, and medication will only reduce the symptoms, and the only way to achieve clinical cure is through surgical (including wire) treatment. There have been many attempts to treat fistulas and perianal abscesses with methods other than surgery, but they have all ended in failure, to say the least, and so far no non-surgical methods have been found to cure them.
The purpose of anal fistula surgery is to cut open the fistula, remove the internal opening, completely eliminate the source of infection, allow the fistula to drain freely, and allow the new granulation tissue to grow upward from the bottom of the wound, gradually filling the wound.
The first thing you need to do is to get rid of the fistula.
The significance of early treatment of anal fistula is that firstly, it can prevent anal fistula from becoming cancerous; secondly, it can reduce the difficulty of treatment by repeated local septic formation of multiple fistulas; thirdly, it can reduce pain and protect anal function from being affected.
In the past, it was thought that anal fistula was a chronic inflammatory disease and usually did not become cancerous, but in recent years, cases of anal fistula becoming cancerous have been reported one after another, which should be given great attention. The cause of anal fistula cancer is not well understood, but it is generally believed to be due to the destruction of the lymphatic structures in the area and the reduction of the immune guardianship that inhibits intercellular degeneration or malignancy. When a fistula becomes cancerous, it is usually difficult to preserve the anus with surgical treatment because it is located in the anal region. Therefore, the only way to prevent fistulas from becoming cancerous is to treat them as early as possible.
The majority of fistulas start out as simple fistulas, but as they recur, they become complex fistulas with multiple fistulas, or they develop deeper into high fistulas, making surgery more difficult. As the number of fistulas increases and their location goes up, not only is the scar around the anus heavier, but the muscle ring outside the anus and rectum must be cut off during surgery to achieve healing, which is not only more painful and takes longer to heal, but most importantly, the function of the anus will be affected, leading to varying degrees of anal incontinence. The actual fact is that you can find a lot of people who are not able to get a lot of money for the purpose of the actual project.