Anal Fistula and Treatment Options: Your Questions Answered

What is an anal fistula?

It is an abnormal connection between your anal canal (back passage) to the surrounding skin. It can occur due to various reasons explained below.

What causes anal fistula?

Most fistulas are caused by simple hair follicle infection that was not treated completely/properly.

There are millions of hair follicles in one’s body. Any one of them around the anal canal can get infected. Infection is more in people who sit for long time and more so among those who sit in unhygienic or hot/sweating environments (e.g., long-distance drivers). When the infection occurs and there is pus collection, the pus needs to be drained properly for the chances of fistula formation to decrease drastically.

If pus is not drained properly, then the body has to discharge the pus, and there are only two directions. If it bursts out of skin and infection gets completely cured, then a fistula does not form. If it bursts into the anal canal, then a fistula is formed. Worst case is when it bursts into the skin but residual infection spreads slowly in different directions. In such a case, a complex fistula is formed. There are certain conditions such asCrohn’sthat predispose one to having fistula. These conditions are rare in India.

Are there different kinds of fistulas?

Fistulas can be classified depending on the involvement of sphincter muscles and internal opening as shown in the picture

What are the symptoms of  a fistula?

A fistula might be characterized by recurrent discharge of pus around the back passage, which stops and starts. People end up taking antibiotic each time, and with time, the fistula will become more complex and difficult to treat. If there is a collection of pus, then it canbe present at in the form of an abscess. In this case, the abscess needs to be treated first and then fistula at a later stage.

How is fistula treated?

The only way to cure a fistula is by surgery. Most fistulae are simple and do not involve sphincter muscles, so cutting it out fully will cure the fistula. If a fistula involves sphincter muscles, then cutting out the fistula in one operation is not a solution as it might cure the fistula, but it will cause one incontinence. If sphincters are damaged, one would loose control over the passing of stool and might have to run to toilet every time one gets sensation. There might also be involuntary passing of stool. In these scenarios, the patient will need to keep clam and undergo two/three operations.

Get More:-Anal Fissure Surgery in Bangalore

Changing Face of Colorectal (Bowel) Cancer

Colorectal cancer is cancer affecting the large intestine and rectum. There has been a rapid increase in colorectal cancer in India, and this can be attributed to two factors:

• Increasing life expectancy
• Following the western lifestyle

Most cases occur above the age of 50. It is true that if detected early, then colorectal cancer can be cured.

How does colorectal cancer develop?

Contrary to belief, it takes years to develop colorectal cancer. It develops from the inner lining of the bowel (mucosa). Initially, it forms a polyp, which over time turns into cancer. The tumour then starts to invade through different layers of the bowel wall and into the lymph nodes near it. If undetected, it can eventually spread to different parts of the body.

Can polyp be treated?

Yes. Most polyps do not contain cancer cells. Removal of polyp will be sufficient to prevent the cancer from developing.

In some cases, even after removing the polyp, cancer cells may be found. If the cancer cells have spread to the colon, then further surgery is advised if necessary.

What are the risk factors for colorectal cancer?

• Increases with age
• Western lifestyle
• Genetic factor (first-degree relative having colorectal cancer)
• Long-term inflammatory bowel disease (Crohn’s or Ulcerative colitis)

What reduces colorectal cancer?

• Hormonal replacement therapy for women
• Vegetarian diet

What are the symptoms of colorectal cancer?

Initially, there might be no symptoms or very few symptoms. The symptoms would increase when the cancer grows in size. The symptoms include:

• Change in bowel habit either to constipation or to passing too many times
• Sensation of incomplete emptying after passing motion
• Blood mixed with the stool
• Passing mucus with stool
• A sensation of fullness after eating little
• Abdominal distension
• Abdominal pain
• Weight loss

Read Full Articel: Colorectal surgeon in Bangalore

Symptoms of Esophageal Cancer & How to Cure?

Esophagus is the pipe which takes food from the mouth to the stomach. It usually affects people above the age of fifty-five years. Since the outcome of oesophageal cancer is not good, anyone suspected of Oesophageal Cancer should be diagnosed at the earliest.

For instance, one with a new onset of dysphagia of less than fifty-five years of age need to be diagnosed.

Like any other cancers, Oesophageal Caner arise from the innermost cell lining of the Oesophagus. In upper, two-third of Oesophagus is usually Squamous cell cancer while in the lower, one-third of Oesophagus is Adenocarcinoma.

There are Numerous Risk Factors for Oesophageal Cancer:

Age: Common in people less than fifty-five years of age

Diet: High fat or processed food are the risk factors

Smoking

Alcohol

Where we live: Common in China

GERD/GORD: Long term infalmmation can lead to cancer in theone-third where initially the cells change nature because of reflux of acid (Barrrett’s Oesophagus). One in hundreds of these conditions can turn to cancer.

Chemical carcinogens: Long term exposure to chemical carcinogens (Specific to India like Tobacco/Gutka/Thambaku)

Symptoms of Oesophageal Cancer Include:

Difficulty in swallowing (Dysphagia): Commonest symptom. Seventy-five percent Oesophagus has be occluded by the Oesophagus for one who experiences Dysphagia. Hence, more than fifty-five percent of people have advanced diseases at the time of diagnosis.

Vomiting: Especially after food

Painful swallowing (Odynophagia)

Weight loss

Vomiting blood (Haemetemesis)

Hoarse voice

Confirming whether one has Oesophageal Cancer is done by Gastroscopy (Type of Endoscopy) and biopsy. Once the cancer is confirmed with biopsy one has to be assessed for stage of the cancer which is usually done by CT scan of chest, abdomen and pelvis. One might also need Endoscopic Ultrasound or PET CT and this would be decided by the treating specialist on individual basis.

One or combination of above tests would tell us whether the cancer is confined to Oesophagus or it has spread to other parts. It would also tell us to which part of the body cancer has spread to. This process is called staging. Treatment of the cancer depends on the stage of the cancer.

Read Full Article: Esophageal Cancer