Knowledge Base

Anal Fistula

by Dr Vaid Ji on Sep 09, 2023

Anal Fistula

Fistula is an abnormal connection between two body parts, such as an organ or blood vessel and another structure. It occurs usually due to the result of an injury or surgery. Infection can also cause a fistula to form. Fistula occur in many parts of the body, fistula form between – an artery and vein, the cervix and vagina, neck and throat, the space inside the skull and nasal sinus, the bowel and vagina, the stomach and surface of the skin, the navel and gut, the colon and surface of the body causing feces to exit through an opening other than the anus.

Inflammatory bowel disease (IBS) such as ulcerative colitis or Crohn’s disease can lead to cause fistulas between one loop of intestine and another. Injuries can cause fistulas to form between arteries and veins.

What is an anal fistula?

Anal fistula is usually a side effect of anal abscess, an infected wound that drains pus from your anus. It usually develops in the upper part of your anus where your anal glands are, when these glands become infected, drainage from the infection can create a fistula, this infection is called perianal abscess.

Causes of Anal fistula

The common cause of anal fistula is perianal abscess which forms over an infected anal gland. Abscess is a pocket of pus that develops at the site of infection. The pus needs to drain away and it creates its own drainage channel to the outside. Other causes of anal fistulas include-

  • Inflammatory bowel diseases, such as Crohn’s disease
  • Tuberculosis affecting your anus
  • Traumatic injury or previous surgery in your anus
  • Anal sexually transmitted infections
  • Radiation therapy for cancer in your pelvic region

Actinomycosis is a bacterial infection that causes abscesses, sometimes in your perianal region

Symptoms of Anal Fistula

  • Pain and swelling around the anal area
  • Feeling tired and sick
  • Oozing of pus , blood or stool from the tunnel opening
  • Fluid drainage from somewhere around your anus, it includes pus or blood.
  • Fever
  • Pain when you pee
  • Swelling and redness inside or around your anus, these are signs of active infection under the skin
  • Pain in the rectum and anus, especially when sitting or passing stool
  • An opening on the skin around the anus
  • A red inflamed area around the tunnel opening

Risk factors

Risk factors for anal fistula include:

  • Crohn’s disease or other inflammatory bowel disease
  • Trauma to the anal area
  • Infections of the anal area
  • Surgery or radiation for treatment of anal cancer
  • Have or have had a perianal abscess in the past
  • Have a chronic STI
  • Are immunocompromised or prone to more frequent infections

Complications of Anal fistula

  • Fistula extension, a chronic fistula rarely extend in new directions, creating new branching channels openings in your skin, these complex fistulas are more difficult to repair
  • Cancer, anal cancer has occasionally been found in longstanding anal fistulas that have been present for years. Chronic inflammation and erosion are known risk factors for cancer.
  • Persistent infection, fistula that stems from abscess or infection keeps the infection active. The infection seems to go away at the original site but then return, forming a new abscess and causing pain.

How to prevent fistula?

  • Eat a balanced diet, adding cereal food and fibers to your diet will aid in softening your stools and make the bowel movements easier.
  • Notice what types of food you are allergic to or what types of food upset your stomach
  • Use pillows, sitting long hours at work is one of the most common causes of fistula. Avoid putting extra pressure on your back, butt and legs especially if you have an anal fistula.
  • Drink more water, excess water will make waste softer and clean the intestines this is why if you drink excessive amounts of water you will need to enter the toilet more often. Water prevents the intestines from getting blocked especially with digestive diseases.
  • Maintain good personal hygiene, change towel each time you bath to prevent the spread of germs and growth of bacteria which can reduce perianal irritation. Make sure to wash after going to the toilet or each bowel movement, any bacteria remaining on the skin causes infection.
  • Strengthen your immune system, exercising, drinking more water sleeping well
  • Practice healthy bowel habits, given enough time to pass bowel movements comfortably, but do not sit on the toilet for too long, gently clean after each bowel movement and keep the anal area dry.

Management of fistula according to Ayurveda-

 In Ayurveda factors like asthi kshanan , straining during defecation , utktasana and krimi bhakshan vitiate the doshas in the body and causes boil formation in the perianal region which suppurates and bursts and leads to bhagandar .

Ayurvedic treatment for fistula-

  • Ushnodaka avagaha (hot sitz baths)
  • Shastra karma
  • Ksharasutra chikitsa
  • Lepa , coating the affected body part with medications.

Herbs for fistula-

  • Aragvadha
  • Triphala
  • Haritaki
  • Krishna tila

 Yoga asana for anal fistula-

  • Vajrasana
  • Malasana
  • Balasana
  • Adho mukha Svanasana

Fistula Care Kit

1. Panchasakar Churan –
Panchsakar churna is a herbo mineral and purely ayurvedic formulation. It mainly works on your Vata and pitta dosha of your body. It can cure Chronic Constipation and help relieve symptoms of Acidity, indigestion, Belching and colic pain. It acts as a mild Laxative and reduces Bloating. It works very efficiently on a disease named IBS (Irritable bowel syndrome) which is very common nowadays that affects your day to day activities. CAC Panchsakar churna is 100% natural and pure.
Recommended Dosage: Take 1 teaspoonful at bedtime with lukewarm water.

2. Triphala Syrup –
Triphala has been used in Ayurveda for many years to treat many diseases. As it is used to detoxify the body and also supports the immune system. It is the best anti-inflammatory, anti-bacterial, anti-viral properties. The syrup is made up of Bibhitaki, Haritaki, Amalaki. Each fruit is thought to positively impact’s the body’s three doshas.
Recommended Dosage – Take 2 teaspoonfuls thrice daily.

3. Arsh Care Tablet –
Arsh care tablet are pure Ayurvedic formulation. These tablets contains pure extract of Reetha Chhilka (Sapindus mukorossi) purified in Cow’s milk. The herb used for formulation of these tablets show antioxidant, anti-inflammatory, laxative properties. It makes your stool soft and help prevent constipation. It is effective against bleeding piles and reduce the pain, burning sensation,irritation while defaecation, treat Fissures, Fistula.
Recommended Dosage – Take 2 tablets twice daily.

4. Jatiyadi Ghrita Lepam –
It is the best ayurvedic herbal remedy that can be used externally to get relief from the swelling, redness, discomfort, itchiness of the piles. It is very effective in calming the imbalance pitta. This lepam is formed from Patola, Nimba patra, Tuttha, Jati patra, etc. It possesses excellent antimicrobial activity and is very effective in controlling piles and fistula.
Method of Application – Apply the lepam on the affected area.

5. Kaishore guggulu Tablet –
Kaishore guggulu Tablet is a herbo- mineral 650 MG tablet. CAC Kaishore Guggulu tablet helps in balancing Pitta dosha in our body. Kaishore guggulu is an ayurvedic guggul formulation used for raised uric acid, Blood purification, mild to severe attacks of Gouty arthritis, inflammatory diseases, Wounds, Indigestion, Constipation, Loss of appetite, Diabetic carbuncles etc. Kaishore guggulu contains pure herbal ingredients such as Guduchi (Tinospora cordifolia), Amla (Emblica officinalis), Bibhitaki (Terminalia bellirica), Haritaki (Terminalia chebula), Shuddha Guggulu (Commiphora mukul), Shunthi (Zingiber Officinale), Kalimirch (Piper Nigrum), Pipali (Piper Longum), Vidanga (Embelia Ribes), Nisoth (Operculina Turpethum), Danti Mool (Baliospermum Montanum), Goghrita etc. These herbs helps in regulating metabolism, cleans out toxins from the body and boosts immunity.
Recommended Dosage – Take 1 tablet twice daily.