The abnormal tube formed in the anal canal or rectum that is connected to the skin around the anus for pathological reasons is called anorectal fistula, or anal fistula for short. In Chinese medicine, it is also called hemorrhoidal fistula or anal leakage, and in folklore, it is also called “rat hole”, which is characterized by an anal fistula with an internal opening in the rectum and an external opening through the perianal skin of the anorectum. The fistula often has a purulent discharge from the external opening, and every time the external opening closes, it causes local swelling and pain, and then pus breaks out again at or near the original opening, and so on, repeatedly. Anal fistula is a common anorectal disease, and studies have found that fistulas that do not heal over time, especially those older than 10 years, have a certain cancer rate. The peak age of onset is 20 – 40 years old, more in men than in women, and is related to the high secretion of sebaceous glands, one of the sex hormone target organs in men. Anal fistula has some special characteristics compared to general anal diseases, and the postoperative recovery time is longer than that of general anal diseases, especially for some patients with high-grade complex anal fistula.
In addition to surgery, postoperative medication changes and care are also crucial to the treatment and postoperative recovery of anal fistulas. Therefore, patients with anal fistula are required to actively cooperate with the doctor’s treatment and pay sufficient attention to postoperative care of anal fistula, especially self-care after discharge. It is recommended that after discharge from the hospital.
1. eat a light diet and pay attention to dietary hygiene.
Avoid eating spicy and irritating foods January, such as wine, onions, garlic, peppers, etc.; instead, eat fiber-rich foods, such as green vegetables, bamboo shoots, etc. Eat less fish, shrimp, crab and other hair and fried and smoked food; should eat more light and easy to digest food as well as fresh fruits and fresh vegetables, diet should pay attention to cleanliness, to prevent diarrhea; watery stool fecal debris easy to block the anal sinus, causing infection.
2, to develop good bowel habits, to keep the bowels unobstructed.
Chinese medicine surgical treatment of anal diseases, has always advocated natural defecation, does not require a daily stool, but requires that according to the actual situation of individuals, at any time the intention to defecate, do not wait not tolerate, which has shown many advantages in our centuries of clinical practice. However, natural defecation is not the same as arbitrary defecation, especially within 24 hours after surgery in the anorectal department, and defecation should be avoided as much as possible. The number of bowel movements per day should be limited to 1-2 times.
3. Pay attention to the cleanliness and hygiene of the anus and insist on taking a sitz bath after the stool.
The anorectum still needs a relatively clean environment, so it is advocated that the anorectum should be cleaned in a timely manner after discharge from the anorectal surgery.
4, appropriate rest, avoid overwork.
Rest is very important to reduce postoperative bleeding and local symptoms of the anus, so we recommend patients to rest appropriately and avoid heavy physical labor.
5.Adhere to anal function exercise.
It is a simple and practical method of anal function exercise, which has the dual role of prevention and treatment of anal diseases, and is advocated at home and abroad.
6, after discharge from the hospital anal fistula recurrence.
The view that anal fistulas, especially high-grade complex fistulas, have a certain recurrence rate after discharge is recognized by the anorectal community. Especially for high, complex hoof-shaped anal fistulas, it may take two or even more operations to heal. No surgeon can guarantee that an anal fistula can be cured once without recurrence. Although our hospital has the advantage of more than 100 years of research in the anorectal specialty and is a leader in the treatment of anal fistulas, there is still a recurrence rate of about l%. Therefore, patients should be vigilant and should go to the hospital for follow-up if they have anal swelling and pain, perianal discharge or fever after discharge.
7. Blood in the stool after discharge.
If there is a little blood on the surface of the stool, symptomatic treatment can be given after the stool; if there is more bleeding and the blood is bright red and cannot be stopped by itself, the patient should go to the hospital for follow-up consultation in time.
8, postoperative anal function damage.
Anal fistula is a chronic infection of the perianal tissue and forms a fibrotic canal. The key to surgery is to drain the internal opening smoothly. The infection at the internal opening spreads through the anal sphincter to the perianal tissues and opens to the skin. Therefore, surgery will inevitably damage the anorectal ring, especially in patients with high-grade complex anal fistulae, sometimes with large postoperative scars and poor elasticity. A small number of patients may have incomplete closure of the anal contraction and may have temporary urgency, anal overflow, dampness, itching and other symptoms.
These are normal phenomena, there is no need to panic, patients can use our fumigation bath with local massage and anal function exercise to get relief, if the relief is not obvious, or even aggravated, need to come to our hospital in time for review. If the relief is not obvious, or even aggravated, you need to come to our hospital for review.
9. Outpatient follow-up after discharge and regular re-examination within half a month.
The number of check-ups varies depending on the severity of the disease, and is usually ordered by the doctor at the time of discharge; if there is discomfort after discharge, it is necessary to return to the hospital for examination and treatment as soon as possible.