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The anal fistula or fistula-in-ano is a passage that connects the inside of the anus to a hole in the skin somewhere around the anus. This abnormal passage usually develops when an infection in the anal glands causes abscess formation — a pus-filled sac. The pus from the abscess creates this passage attempting to drain out.
The external opening of the anal fistula, the one on the skin near the anus, appears as a hole. Pus, blood, and sometimes even portions of stool may be discharged through this hole.
According to thestatistics, anal fistula develops in 18.37 people out of 100,000 in Europe. It affects about20,000 to 25,000 people in the USA each year. The prevalence of anal fistula is high among males.
You can tell if you are getting a fistula if you experience signs and symptoms such as:
The main cause of a fistula is the development of an abscess in an infected gland.
Inside the anus, there are several glands present. When these glands get clogged, an infection occurs over the glands, and a severe infection can lead to an abscess formation.
Pus released from the abscess starts eroding the surrounding tissues to make its way out of the body. In many cases, it leads to the formation of a fistula. According to thereports, 40 to 66% of abscesses lead to fistula formation.
Some other conditions that can cause the development of anal fistula include:
Surgical procedures are the best treatment options for a fistula. Your surgeon will choose from several types of surgical options depending on the location, condition, and type of fistula.
Some common surgical procedures for anal fistula include:
Reports show that people undergoing fistulotomy have a healing rate of 90%.
Reports show that the healing rate of anal fistula from endorectal advancement flap procedure is between 66 to 87%.
Reports show that the seton placement procedure has a healing rate of 94% for anal fistula.
Medications are not a preferred treatment option for anal fistula. Antibiotics are prescribed only when the immune system is compromised, as inHIV patients.
Whether a fistula treatment requires surgery or not, it depends on the type and condition of the fistula. There are some non-surgical options to treat a fistula. These include:
However, the fibrin glue injection is less effective than other surgical procedures and has a healing rate ofless than 50%.
Study shows that laser treatment for fistula is less painful and quicker but has the drawback of a higher recurrence rate.
Medical management for the anal fistula has its lackings, either it is surgical procedures or non-surgical procedures. The best practice should include dietary and lifestyle changes alongside medical management to reduce discomfort and promote complete recovery.
By practicing home remedies and adopting some lifestyle changes, you can promote the healing of a fistula. Here are some tips that can lower your discomfort and ease symptoms of fistulas:
A sitz bath is a shallow water bath in which a person sits and the warm water is filled up to the person's hips. It helps reduce discomfort from the anal fistula by reducing irritation, swelling, and pain.
Research shows that different types of sitz baths are effective in treating complex anal fistula.
A diet for fistula should not contain overly processed foods and must include a major portion of plant-based foods.Overly processed foods can promote inflammation and worsen discomfort.
In contrast, plant-based food items high in fiber helpreduce inflammation and facilitate the healing process in the body. A fiber diet also preventsconstipation and causes less strain during bowel movements. Constipation and strain during the bowel movement can disturb the fistula and aggravate the symptoms.
Drinking plenty of water keeps the gastrointestinal contents moving. It helps form soft stool, which translates to alower risk of constipation and less strain during bowel movements. Regular and strain-free bowel movements help with the natural healing of the fistula.
Hygiene for the fistula is essential to prevent bacterial infections. After a bowel movement, you must wash the rectal area thoroughly. Drain pus and other wastes coming out of the fistula, and then clean the outer opening and surrounding area of the fistula.
Change the underclothings several times a day if the fistula leaks continuously.
It is essential to understand that despite all the treatments and remedies available, managing fistulas can be really painful. To avoid experiencing this discomfort, you must adopt diet and lifestyle changes to prevent the development of fistulas in the first place.
According to theresearch, there is a greater risk of developing anal fistula among people with a sedentary lifestyle andobesity. Constipation and straining during bowel movement can also facilitate the development of anal fistula.
Foods to prevent fistula must have anti-inflammatory properties, be low in calories, and support digestive health. Here are some such foods:
Fibersoftens the stool by adding more volume, thus preventing constipation. It also prevents straining during bowel movements and lowers the risk of triggering a fistula. Fiber alsohelps in managing obesity, which is a risk factor for developing anal fistula.
Research also shows that dietary fiber has anti-inflammatory properties and is associated with lowering the risk of infectious diseases.
Add plant-based foods such as fruits and vegetables to your diet as they are excellent fiber sources. Some common examples of fiber sources include:
Although you can drink plenty of water to lower the risk of constipation, addingwater-rich foods to your diet also helps significantly. Adequate water intake helps soften the stool and causes less strain during bowel movements.
Water-rich foods such as fruits and vegetables not only help with hydration but also provide plenty of healthy nutrients. Some common water-rich foods include:
Fats usually don’t have a good reputation as a dietary component, butnot all fats are bad. According toseveral studies, unsaturated fats – fats that are liquid at room temperature — have anti-inflammatory properties.
The anti-inflammatory effects of fats can lower the risk of inflammation in the anal glands and prevent abscess formation. Some excellent sources of unsaturated fats include
Fiber reduces the possibility that a strain during a bowel movement will interfere with the fistula's natural healing process. Hard stools can cause strain during bowel movements, which can worsen the anal fistula and elevate the symptoms. Fiber helpsprevent hard stool formation by adding bulk to the stool, thus making bowel movements easy.
Fiber also has anti-inflammatory properties and can promote tissue recovery. Astudy shows that dietary fiber is effective in wound healing and scar formation.
Probiotics can prevent bacterial attack and infection in the fistula, promoting natural healing.Studies show that fiber has probiotic properties and can help the body fight infection-causing pathogenic bacteria.
So, if you have an anal fistula and you are looking for a diet to ease your symptoms and promote healing, fiber is a great option. You can get dietary fiber from fruits, vegetables, whole grains, nuts, and beans.Fiber powder is also a convenient way to include fiber in your diet.
Foods to avoid for anal fistula include:
Spicy foods can irritate the gastrointestinal tract by increasing its acidity. AStudy showed that consuming spices can cause abdominal pain and burning sensations. This can lead to pain, bleeding, and irritation in the fistula.
Research shows thatoverly processed foods can trigger inflammation in the gastrointestinal tract. Poor digestive health can lead to increased discomfort and elevated symptoms of anal fistula.
Foods that are low in fiber can greatly increase the risk of fewer bowel movements and hard stool formation. Hard stools are difficult to pass and can put pressure on the anal fistula. This can lead to bleeding and pain in the fistula.
Caffeine has a diuretic effect, as itincreases water loss from the body through urine. Increased consumption of caffeinated drinks can lead to dehydration, which can cause hard stools. Hard stools put extra strain on the fistula during bowel movements and can worsen the symptoms.
Fistula, if left untreated, can disturb the quality of life and can lead to severe complications such as sepsis. Fortunately, several effective treatment options for fistulas are available, so it is not recommended to leave the condition untreated.
Eggs have anti-inflammatory properties, and egg protein can promote the healing of infected tissues. You can eat eggs in moderation with a fistula.
Juices high in fiber are the best choices for fistula. They provide the benefits of fiber and keep you hydrated. Common examples of high-fiber juices include prune and pear juices.
Yogurt has probiotics that can promote gastric health and help the body fight pathogenic bacteria. Thus, it can lower the risk of infection and discomfort.
I hope this article helped you learn about anal fistulas, how they form, and available treatments as well as what to eat to prevent these altogether.