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anal abscess, anal fistula

Anal fistula: what is it?

The anal fistula almost always results from a preexisting abscess. Inside the anus are small glands; if, for any reason, they become closed, they can become infected, and in this way an abscess can develop, which precisely is aninfected, pus-filled cavity that is located in the vicinity of theanus or rectum. The anal fistula is actually a channel for abscesses to drain outward, putting them in communication with both the skin near the anus and the rectal cavity.

How is anal fistula formed and how is it treated?

Abscess results from infection of an anal gland, when bacteria or foreign materials enter the glandular tissue. Certain conditions-such as colitis or other inflammation of the intestines-can sometimes promote the development of such infections. After the abscess is drained, a channel connecting the anal gland, in which theabscess was formed, with the skin may persist. This is the anal fistula. If this occurs, there may be secretion of purulent, or even fecal, material through the superficial opening of such a tunnel. If the opening closes, the abscess may recur. An abscess does not always give rise to an anal fistula: fistulas develop in about 50 percent of anal abscess cases, and there is no way to predict their occurrence .

Normally, patients with perianal abscess complain of pain and edema near theanus. Fatigue, fever and chills may also be experienced. Symptoms associated with the presence of an anal fistula are irritation of the skin around theanus, discharge of pus or fecal material (or even sometimes gas)-events that often relieve pain, fever and general malaise

Treatment ofperianal abscess consists ofincision of the skin for the purpose of draining the pus contained in the abscess cavity. Drainage can often be performed on an outpatient basis under local anesthesia. If the abscess is large is deep, drainage is performed in the operating room, with the assistance of the anesthesiologist, and hospitalization of the patient becomes necessary.

Anal fistula surgery

The treatment of anal fistula is surgical. Although surgery can be, in most cases, relatively simple, it can be fraught with complications, and it must be performed by an experienced coloproctologic surgeon.

Often, the surgery requires only a few hours of hospitalization. However, in cases of deeper and more extensive fistulas , the surgery may be more complex and the hospitalization longer. The postoperative is usually mild, and usually no special therapy is required except for taking occasional pain medication. Return to school or work is usually rapid. It is helpful to supplement the diet with fiber to soften the stool as much as possible. Defecation does not affect the healing process.

If healing occurs properly, recurrence of anal fistula, while possible, is rare.

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