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Fistula FAQs

Following are the common questions about Fistula:

  1. What is a fistula?
  2. What are the different types of fistula?
  3. How does fistula form/develop?
  4. What are the causes of fistula?
  5. What are the symptoms of fistula?
  6. Who is an ideal person to treat the fistula?
  7. What tests are done before fistula treatment?
  8. How is fistula treated?
  9. What is fistulectomy?
  10. How long does fistula surgery take?
  11. Do I need hospitalization after fistula surgery?
  12. What is the cost of fistula surgery?
  13. What factors affect the overall cost of fistula surgery?
  14. What is the best surgical treatment of fistula?
  15. What happens during fistula laser surgery?
  16. What are the benefits of choosing laser surgery for fistula treatment?
  17. When to see the doctor after fistula surgery?
  18. What is the advice for a patient suffering from a fistula?
  19. Can fistula be left untreated?

Q. What is a fistula?

A. Unhealthy lifestyles, bad eating habits, less water intake, and alcohol and tobacco consumption have increased fistula cases in India. Fistula, also known as the anal fistula, is a small tract that forms between the internal and external opening near the anus.

Few medical studies show that around 23% of India's population has fistula. Also, 28% of individuals with anal abscesses and 12% with underlying anal diseases have developed fistulas.

Research states that around 50,000-1,00,000 women are affected by obstetric fistula worldwide every year. Almost 76% of patients with fistula preferred to undergo laser surgery, 14% choose to undergo open surgery, and the remaining 10% choose to follow home remedies, lifestyle, and dietary changes.

Q. What are the different types of fistula?

A. Fistula often occurs in the genital and anus region (medically known as the perineum). There are four types of fistula, including:-

  • Enterocutaneous fistula:- This occurs mainly from the intestine to the skin. This type of fistula may be a complication of surgery. It’s described as a passageway from the intestine to the surgical site and then to the skin.
  • Enteroenteric or Enterocolic fistula:- This fistula involves the small and large intestine.
  • The enterovaginal fistula is an abnormal opening that connects the vagina to another organ such as the bladder, colon, or rectum.
  • Enterovesticular fistula:- This is also known as vesicoenteric fistula or intestinovestical fistula, which occurs between bowel and bladder.

Q. How does fistula form/develop?

A. The glands inside your anus that make fluids sometimes get blocked or clogged. When this happens, a bacteria buildup may create a swollen pocket of infected tissue and liquid, which is known as an abscess in medical terms.

If the abscess is not treated on time, it grows and makes its way to the outside and punches a hole in the skin in the anal region to drain the pus inside it.

However, when the abscess did not heal completely, it caused fistulas. Experts also believe that abscess causes fistulas in most cases.

Q. What are the causes of fistula?

A. Several factors contribute to the formation of the fistula. However, the following are the most common causes of fistula:-

  • Abscess
  • Tuberculosis
  • Chronic diarrhea
  • Chronic constipation
  • Lifting heavyweights
  • Prolonged anal fissure
  • Straining during bowel movements
  • Sexually transmitted diseases (STDs)

Q. What are the symptoms of fistula?

A. Fistula symptoms help you and your doctor become sure that you are suffering from fistula. The doctor also performs diagnostic tests and then treats the problem based on the severity of fistula symptoms.

Following are the most common symptoms of fistula:-

  • Skin irritation
  • Frequent fever
  • Discharge of pus
  • Pain in the anal region
  • Recurring anal abscess
  • Bleeding from the anus
  • Swelling around the anus
  • Redness in the anal region
  • Pain and straining during bowel movements
  • Itching, inflammation, and discomfort in the anal region

Contact a doctor immediately after you notice any of these symptoms in yourself. Early medical intervention can help you cure the disease very quickly and permanently.

Q. Who is an ideal person to treat the fistula?

A. A proctologist is an ideal medical professional to treat fistula. A proctologist, also known as a colorectal surgeon or colon and rectal surgeon, specializes in diagnosing and treating the lower gastrointestinal tract (colon, rectum, anus).

Q. What tests are done before fistula treatment?

A. Before treating a fistula, a proctologist first recommends specific diagnostic tests to confirm the type, cause, and severity. The diagnostic tests are done before fistula treatment includes the following:-

  • Anoscopy
  • Colonoscopy
  • Digital rectal exam
  • Endorectal exam
  • Endorectal ultrasound
  • Proctoscopy
  • Sigmoidoscopy

Q. How is fistula treated?

A. Surgical procedures are the only treatment options for fistula. Fistula surgery is done in two ways: open surgery and laser surgery.

Q. What is fistulectomy?

A. Fistula surgery, also called fistulectomy, is where the surgeon removes the fistulous tract. Several treatment options exist for fistula treatment, but laser surgery is considered the most effective treatment.

Q. How long does fistula surgery take?

A. Usually, fistula surgery takes around 30-60 minutes to complete. But depending on the type, severity, and surgical procedure, the duration may be shorter or longer.

Q. Do I need hospitalization after fistula surgery?

A. After open fistula surgery, you may need hospitalization for 1-2 days. However, fistula laser surgery is a daycare procedure, so you don’t need to stay at the hospital. After a few hours of your surgery, the doctor will discharge you from the hospital.

Q. What is the cost of fistula surgery?

A. The average cost of fistula surgery ranges between Rs. 40,000-70,000. However, that’s not the final or fixed cost. It may vary from case to case as several factors decide the overall cost of fistula surgery.

Q. What factors affect the overall cost of fistula surgery?

A. Many factors affect the overall cost of fistula surgery. However, the following are considered the primary factors:-

  • Type of fistula
  • Diagnostic tests are done before fistula surgery
  • Type of surgical treatment
  • Experience, qualification, and reliability of the doctor
  • The fee of the anesthetist
  • Location and specialty of the hospital
  • Hospitalization post-procedure
  • Postoperative medications
  • Follow-up visits with the doctor

Apart from all the mentioned above, several other factors can affect the final cost of fistula surgery, such as insurance coverage, different surgical procedures in case of emergency, other payment options, etc.

To know the approximate cost of fistula surgery, we suggest you directly contact the healthcare service provider and discuss the same.

Q. What is the best surgical treatment of fistula?

A. Laser surgery is considered the easiest, safest, quickest, and permanent fistula treatment. It is a bloodless and painless surgical procedure that takes around 30-60 minutes. Laser surgery for fistula has gained popularity across the globe due to its effectiveness and benefits.

Usually, the patients are discharged the same day after 2-3 hours of rest post their surgery. Laser surgery for fistula involves no cuts, stitches and results in wounds or scars.

There are almost no chances of infections. Laser surgery has brought an easy and convenient cure for fistula. This surgical procedure offers instant relief to the patient.

Q. What happens during fistula laser surgery?

A. During fistula surgery, the surgeon inserts a precise amount of laser energy into the fistula through a thin laser probe and destroys the fistula for once and all. After that, the laser probe is pulled back while closing the fistula tract.

The surrounding tissues are left intact throughout the surgical treatment. The recovery after laser surgery is speedy and comfortable. We advise you to avoid strenuous work for the few days following your surgery.

Q. What are the benefits of choosing laser surgery for fistula treatment?

A. The following are the top benefits of choosing laser surgery to treat fistula.

  • Almost no pain
  • Daycare procedure
  • No restriction on diet
  • No need for hospitalization
  • Least preparation required
  • A short and precise procedure
  • It does not require any medication
  • Involves no cuts, wounds, or scars
  • Resume your daily routine in 48 hours
  • Complications during or after surgery are minimum

You can resume your daily routine two days after the surgery. You should ensure that you follow the diet chart that your doctor has suggested to you. You will be fit and fine within a week.

Q. When to see the doctor after fistula surgery?

A. When you reach home post yur surgery, you must follow all the instructions given by your doctor. Whether it be diet or exercise, following all the instructions help in recovering quickly.

However, if you notice any of the following signs and symptoms post-surgery, see your doctor as soon as possible.

  • Pain
  • Fever
  • Nausea
  • Vomiting
  • Inflammation
  • Lack of bowel control
  • Redness in the anal region
  • Swelling in the affected area
  • Swelling of lymph nodes in the groin

The chances of experiencing these symptoms are rare post your fistula laser surgery. However, if you observe any, do contact your doctor.

Q. What is the advice for a patient suffering from a fistula?

A. Patients suffering from fistula are advised to take adequate liquid (juices), water and eat a healthy and high fiber diet. Doing so leads to the formation of soft stool, which prevents extra pressure during bowel movements.

If you are suffering from a fistula, passing a hard stool can be very painful and challenging. You should maintain hygiene when you use washrooms. Unhygienic conditions can lead to more complications.

There are various ways to treat fistula. But laser surgery is the only treatment method that can cure your disease for once and all.

Q. Can fistula be left untreated?

A. No. Fistula should not be ignored or left untreated. It can potentially cause bleeding, fecal incontinence, skin infections, and sepsis. Contact a specialist immediately after you notice any symptoms of fistula.