Fistula in ano / Bhagandar –

Fistula in ano is a chronic inflammatory condition characterised by tubuler structure.

Classical fistula has two openings one internally in ano rectal canal while another externally on the surface of perianal skin.

Anal fistulae originate from anal glands which are located between the two layers of anal sphincters and which drain into the anal canal. If the outlet of these glands become blocked an abscess can form which can eventually point to the skin surface. The track formed by this process is called fistula.

Anal fistulas do not generally harm but can be irritating because of the pus drain.

Types

  1.  Low level
    •  – Subcutaneous
    • – Sub mucous
    • – Low anal
  2. High level
    • – High anal
    • – Pelvi rectal

Symptoms
– Pain,
– Discharge either bloody or purulent,
– Pruritus ani – Itching at anal opening,
– Systemic symptoms like fever if abscess becomes infected.

Diagnosis is by examination, either in an outpatient setting or under anaesthesia (referred to as EUA — Examination Under Anaesthesia). The examination can be ananoscopy.

Possible findings
– The opening of the fistula onto the skin may be seen,
– The area may be painful on examination.

Investigations
– Probing,
– Fistulogram,
– Proctoscopy & sigmoidoscopy.

TreatmentKshar sutra Treatment – Ayurveda the ancient science of Indian medicine, describes Herbal Setons made from various Salts and Alkaline Herbs used to cure anal fistulae. This treatment, known as “Kshar Sutra Therapy” is very popular in India and considered to be the Safest and the Most Successful treatment of Anal Fistula.