Medical Column - About Fistula A Brief Reflection on Fistula

Director Choi Bong-soo

Today, it is often mistakenly thought to be a common hemorrhoid and easily neglected, but surgical treatment is absolutely necessary.

I will inform you about fistula, a rare but unique anal disease among anal conditions that can develop into cancer if left untreated for a long time.

 

Inside the anus, there are anal glands that secrete anal fluid, which acts as a lubricant during bowel movements.

Generally, about 12 to 16 concentric circles are distributed approximately 2 cm above the anal opening.

Sometimes, fecal debris gets lodged at the opening of this gland, leading to inflammation of the anal gland.

When anal fistula develops, the inflammation takes on two different states of disease.

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One such case is when active inflammation progresses and spreads to surrounding tissues, leading to pus accumulation, which is called an anal abscess.

Another case is when the inflammation gradually progresses toward the skin, creating a pimple-like opening in the skin around the anus.

 

It is called to undergo this.

About 80% of anal abscesses that drain naturally through the skin or become severe enough to require incision and drainage eventually progress to fistulas.

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Patients usually visit the hospital due to lumps around the anus, discharge and bleeding, pain, and recurrent sinus formation and pus drainage.

On examination, an external pustule-like opening with inflammation was observed, along with a firm palpable fistula inside the anal canal.

And if a hard primary lesion can be felt inside the anus, the diagnosis is straightforward.

Ultrasound examinations are also performed to observe the precise condition.

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Depending on the progression pathway of the inflammation, it may descend along the sphincter surrounding the anus, or cross over above the sphincter and descend.

It can also pierce through and loosen the sphincter.

 

Additionally, the inflammation tunnel branches out in the middle, creating multiple external openings on the skin around the anus.

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Fistulas are caused by inflammation that begins on the inner wall of the anus and erupts outward through the skin due to anal pressure.

Taking antibiotics or anti-inflammatory drugs will not lead to natural healing over time.

It is known to be related to overwork, excessive drinking, weakened immunity, spicy foods, etc., and occurs about three times more frequently in men than in women.

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Unlike common fistulas, pediatric fistulas caused by developmental anomalies of the anal glands, and tuberculous fistulas caused by tuberculosis infection.

There are also special types of fistulas, such as Crohn's fistulas, which occur when Crohn's disease of the gastrointestinal tract affects the anus.

Fistula is a chronic inflammatory condition, and if left untreated for over 20 years, it can rarely develop into anal cancer.

Fistulas must be treated with surgery, and proper wound care over 2 to 3 months after the operation is necessary to prevent recurrence.

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Generally, when experiencing anal pain, bleeding, or the appearance of a lump, people tend to think it is simply hemorrhoids.

There are quite a few cases where using hemorrhoid medication or ointments obtained from a pharmacy leads to the condition worsening.

Even if the symptoms are similar, anal diseases such as early hemorrhoids or acute fissures can be treated conservatively.

Some illnesses can be expected to improve, while others, like anal fistula, must be treated with surgery.

 

Therefore, do not miss the treatment timing by self-diagnosis.

Uncomfortable symptoms should be diagnosed and treated by a medical professional.