Disease
Fistula (Anal, Arteriovenous, etc.)

Talk to
Expert

Overview of Fistula

A fistula is an abnormal connection between two organs, blood vessels or tissues that usually do not connect. It can develop due to infections, injuries, surgery or underlying medical conditions. Fistula disease can affect various parts of the body, such as the anus, blood vessels, digestive tract and urinary system.

Types of Fistula

  • Anal Fistula: Forms between the anus and the skin often due to an infection.
  •  Arteriovenous (AV) Fistula: An abnormal connection between an artery and a vein commonly created for dialysis access.
  •  Tracheoesophageal Fistula: A congenital defect connecting the trachea and esophagus.
  •  Rectovaginal Fistula: An abnormal opening between the rectum and vagina.
  •  Vesicovaginal Fistula: A connection between the bladder and vagina leading to urine leakage.
  •  Bronchopleural Fistula: A connection between the bronchial tubes and pleural space.
  •  Oroantral Fistula: An opening between the oral cavity and sinus.
  •  Enterocutaneous Fistula: A connection between the intestine and skin.
  •  Branchial Fistula: A congenital defect in the neck due to improper embryonic development.

Symptoms of Fistula

  • Anal Fistula: Pain, swelling, pus discharge, irritation and bleeding.
  • AV Fistula: Swelling, pulsating lump and reduced blood flow.
  • Rectovaginal/Vesicovaginal Fistula: Uncontrolled passage of stool or urine from the vagina.
  • Tracheoesophageal Fistula: Difficulty swallowing, coughing and respiratory infections.
  • Bronchopleural Fistula: Severe coughing and difficulty breathing.

Causes of Fistula

  • Infections: Long standing infections, such as abscesses, tuberculosis or sexually transmitted infections can lead to fistula formation.
  • Inflammatory diseases: Conditions like Crohn’s disease and ulcerative colitis increase the risk of digestive tract fistulas.
  • Complications from surgery: Post surgical healing issues can lead to unintended fistula formation.
  • Injuries or trauma: Accidents, childbirth complications or radiation therapy can create abnormal connections between organs.
  • Blocked glands: Blockage of anal or sweat glands can result in abscess formation leading to anal fistulas.
  • Cancer or tumors: Some types of cancer, especially in the digestive, urinary or respiratory system, can cause fistulas.

Complications of Fistula

  • Repeated infections: If left untreated, a fistula can lead to frequent bacterial infections and abscess formation.
  • Sepsis risk: A severe fistula infection can enter the bloodstream which leads to life threatening sepsis.
  • Malnutrition: Some digestive fistulas prevent the absorption of nutrients, causing weakness and weight loss.
  • Uncontrolled leakage: Vesicovaginal and rectovaginal fistulas result in involuntary leakage, affecting daily life.
  • Chronic pain: Persistent discomfort and pain can reduce a patient’s quality of life.
  • Blood clot formation: AV fistulas can lead to clotting issues and increasing the risk of cardiovascular complications.

Risk Factors of Fistula

  • History of infections: Patients with chronic infections, such as abscesses or tuberculosis are at higher risk.
  • Surgical history: Those who have undergone abdominal, anal, or gynecological surgeries have a higher chance of fistula formation.
  • Inflammatory bowel disease (IBD): Crohn’s disease and ulcerative colitis significantly increase the risk of digestive tract fistulas.
  • Prolonged labor or childbirth trauma: Can lead to rectovaginal and vesicovaginal fistulas in women.
  • Diabetes and weak immunity: Impaired healing increases the risk of chronic fistula development.
  • Cancer treatment or radiation therapy: Can damage tissues, leading to fistula formation.

Preventions of Fistula

  • Early treatment of infections: Seeking medical attention for abscesses and infections reduces the risk of fistula formation.
  • Managing chronic conditions: Controlling Crohn’s disease and ulcerative colitis lowers the likelihood of digestive fistulas.
  • Proper hygiene: Keeping the anal and vaginal areas clean can prevent abscesses and infections.
  • Safe childbirth practices: Seeking skilled medical care during labor reduces the risk of obstetric fistulas.
  • Regular check ups after surgery: Monitoring post surgical healing helps detect complications early.
  • Maintaining a healthy diet: Proper nutrition helps improve tissue healing and prevents digestive fistulas.

Diagnosis of Fistula

  • Physical examination: For anal or external fistulas doctors can often detect the problem visually.
  • MRI or CT scan: Helps in identifying internal fistulas and their connections to surrounding organs.
  • Fistulography: A specialised X-ray using contrast dye to map the fistula tract.
  • Endoscopy or Colonoscopy: Used to diagnose fistulas in the digestive tract.
  • Ultrasound or Doppler Scan: Evaluates blood flow in AV fistulas.

Treatments of Fistula

  • Medications: Antibiotics and anti-inflammatory drugs help control infections and reduce inflammation.
  • Fistulotomy: A surgical procedure to open and heal anal fistulas.
  • Seton Placement: A drainage technique that helps prevent infection before surgical closure.
  • Laser Therapy: A minimally invasive technique used to close fistulas with less pain and faster recovery.
  • Tissue Grafts and Flap Surgery: Used for complex cases where natural healing is slow.
  • AV Fistula Surgery: Surgical creation or repair of an AV fistula often used for dialysis patients.
  • Bowel Rest and Nutritional Support: For digestive fistulas a specialised diet may aid healing.

Prognosis of Fistula

  • Most fistulas can be treated successfully with the right surgical or medical intervention.
  • Recovery time varies depending on the severity and type of fistula. Anal fistulas may take a few weeks while complex ones require months.
  • Minimally invasive treatments improve outcomes and reduce pain and complications.
  • Recurrence can happen so proper post treatment care and follow-ups are essential.

Care at MyhealthMydoctor

  • Expert consultations with top specialists in proctology, vascular surgery and gastroenterology.
  • Advanced diagnosis using cutting edge imaging technology.
  • Minimally invasive treatment options for faster recovery.
  • Personalised care plans tailored to each patient’s condition.
  • Post treatment support and follow up to prevent recurrence.

Some Important Questions Patients Should Ask Their Doctor During a Consultation

  • What is the best treatment for my fistula?
  •  Can my fistula heal naturally, or do I need surgery?
  •  How long will it take to recover after fistula surgery?
  •  Are there non-surgical treatments for fistula disease?
  •  What are the chances of recurrence after treatment?
  •  How can I prevent infections from worsening my condition?

What Patients Expect from Doctors During Consultation?

  • Clear explanation of your condition and treatment options.
  • Honest discussion about surgery, risks and recovery time.
  • Guidance on pre and post surgical care to ensure faster healing.
  • Personalised approach based on medical history and needs.
  • Support and reassurance throughout the treatment process.

Other Diseases