Fistula. The main causes of the fistula

Content

As a result of an inflammatory process or surgical intervention, a so-called fistula can form - a channel connecting two cavities to each other or an organ to the surface of the body. Inside the fistula is filled with exudate, so over time the inflammation progresses. Such a pathology cannot heal on its own; mandatory medical treatment or surgical intervention is required.

What is a fistula

As a result of various pathological processes, purulent fluid accumulates in the focus of inflammation - it consists of bacterial cells along with their metabolic products and dead leukocytes. During the development of pathology, the amount of exudate gradually increases, it does not fit in the cavity, so the body tries to give it an outlet. This is how a fistula is formed - a fistula (tube, channel), which connects the affected cavity or organ to the exit site of the exudate (the surface of the skin or another cavity).

Through the fistula, the surface of which is covered with an epithelial layer or granulation tissue, a purulent secret constantly passes, increasing inflammation, therefore, spontaneous healing of such a pathology is problematic, but in some cases it is possible. In addition, fistulas often have multiple branches, which makes it difficult to surgically remove the pathology.

Under certain conditions, microorganisms from the purulent fluid can “migrate” into the surrounding organs and tissues, provoking the appearance of new foci of inflammation. The composition of the separated substance directly depends on the organ with which the channel is connected; the more aggressive the secret, the more it damages the skin or nearby tissues. When fistulas occur, there is a loss of fluid, intoxication of the body, which leads to metabolic disorders and water-salt balance.

Fistulas can exist in the body for a long time and, if not properly treated, affect several organs. If the inflammation of the original organ stops, purulent secretions stop flowing into the canal, it closes and heals. When the pathological process resumes, the fistula begins to function again, accumulate and secrete exudate - a relapse occurs.

What does a fistula look like

There are internal fistulas, which connect the cavities inside the body, and external ones. A fistula on the skin looks like an inflamed wound, from which pus oozes, the edges may resemble lips (see photo below). An external fistula occurs on the skin of a person near cavities - for example, in the throat and nose. In some cases, a person may not be aware of the presence of an inflammatory process in the body until a fistulous opening appears on the surface of the skin. In case of severe damage to the internal organs, not only purulent exudate, but also fecal, urinary, and bile can be released from the canal.

What does it come from

Gram-negative, anaerobic bacteria, streptococcus aureus, staphylococci, some types of fungi, etc. can act as an etiological factor. Fistulas are formed for the following reasons:

• tuberculosis infection;
• (severe chronic disease of the gastrointestinal tract);
• actinomycosis - chronic diseases resulting from infection with a fungus;
• complications after surgery (for example, a ligature fistula is formed due to suppuration around the sutures on the blood vessels);
• chronic ENT diseases;
• the presence of sequesters - dead areas of the bone;
• injuries of the intestinal tissue;
• dental pathologies (periodontitis, caries);
• - inflammation in the crypts of the anal canal of the intestine;
• neoplasms (benign and malignant) on the rectum;
• suppuration around foreign bodies inside the body (for example, a bullet or its fragments).

Symptoms

The signs of a fistula in most cases are similar, depending on the location of the focus of inflammation and the affected organ. Fistulas can occur anywhere, for example: on the back, buttocks, groin, chest, heel, finger, abdomen, perineum, etc. With pathology, the patient observes the following symptoms:

• subfebrile body temperature due to the presence of an inflammatory process in the body;
• signs of intoxication - weakness, headaches and muscle pain, sleep disturbance, decreased performance;
• the presence of a characteristic pain syndrome if the fistulous course affects the nerve endings (for example, a fistula of the rectum is accompanied by pain in the anus, which intensifies during defecation);
• the pain subsides after the bubble breaks through at the end of the canal and the secretion is released onto the skin or into the cavity.

Kinds

There are several classifications of fistulas. By origin, the following types are distinguished:

1. Congenital fistulas are formed due to malformations of the embryo; some of them (for example, umbilical fistula) are detected by doctors before or during childbirth.
2. Acquired pathological channels arise as a result of inflammatory processes, injuries or operations (for example, a fistula on a leg or arm may occur due to a fracture or bruise).
3. artificially created fistulas are designed to remove fluids from the body (purulent, urinary, fecal, bile).

By location, fistulas are divided into the following types:

1. Urinary- are installed on the ureters, bladder or urethra, formation as a result of trauma is possible.
2. Biliary fistulas occur due to operations on the gallbladder. The secret secreted by such a fistula leaves burns on nearby tissues, so treatment should be started immediately.
3. Purulent channels can appear anywhere on the body, often they appear on the gums due to a poorly healed tooth. In rare cases, a purulent fistula can heal on its own, but more often a relapse occurs and purulent exudate begins to flow through the canal again.
4. Salivary fistulas are formed due to inflammatory processes in the cheek, neck or ear, saliva is secreted through them.
5. Bronchial- connect the bronchi to the pleural cavity.
6. Gastric fistulas are established artificially for enteral feeding of the patient after resection of the stomach with deviations of the digestive system and gastrointestinal tract.
7. There are fistulas of the upper and lower small intestine. The former arise due to injuries or operations, often heal on their own with proper care, the latter are created by surgeons to remove feces in case of intestinal obstruction or peritonitis (fecal fistula).
8. Canals in the large intestine arise as a result of injuries, operations or are established artificially. Often heal on their own, but require special care - the use of protective ointments to avoid injury.

Diagnostic methods

To make an accurate diagnosis, the doctor gets acquainted with the patient's history, palpates the inflammatory focus, evaluates the amount and appearance of the secreted fluid, and asks the patient about complaints about violations of the functioning of internal organs. After that, the doctor directs the patient to further diagnostic measures:

• A blood and urine test, blood culture for the presence of pathogenic bacteria can indicate the presence of inflammation and its nature.
• CT (computed tomography), MRI (magnetic resonance imaging) are often used as a means of diagnosing fistulas.
• One of the most effective methods is radiography with the introduction of a contrast agent into the fistula cavity to determine the size, length, branching of the fistula.
• The probing method is considered no less effective; it is used only in cases of external fistulas, in which the outer edge comes to the surface of the skin.
• Studies of purulent fluid are used to determine the primary organ that gave rise to the pathological canal.
• During the operation to remove the fistula, specialists inject staining substances (for example, methyl blue) to assess the entire structure of the canal and accurately identify the original organ.
• Ultrasound is rarely used to diagnose fistulas, because this method is less informative.

Fistula treatment

In fact, a fistula is a tube with dead remains of bacteria, often its treatment consists in excising the canal, cleaning it chemically or mechanically and removing inflammation of the organ from which the fistula began. For example, when getting rid of the fistula of the rectum, the most effective method is surgery. Full recovery of the patient occurs in 20-30 days, at this time the patient is recommended to take therapeutic baths and refrain from physical activity in order to avoid injury to the sphincter.

Also, for the treatment of fistulas, local remedies are used (baths, ointments, powders, antiseptic solutions for washing, etc.). In some cases, the doctor prescribes antibiotics to eliminate bacterial infection, painkillers and antipyretics to improve the patient's condition. As drugs used for the treatment of fistulas, the following medicines are used:

Folk remedies

Treatment of simple fistulas with medicinal herbs is highly effective. In some cases, there is a complete recovery. Ointments, baths based on natural ingredients are used as medicines. Aloe and cabbage have the most effective therapeutic effect, the juice of these plants helps to remove pus from the fistula and quickly heal the wound. Before using all medicines, the patient should consult with a specialist.

Ointment

The following remedies are used as home ointments:

1. Vodka and olive oil are mixed in a ratio of 1: 1, the affected area is treated with the mixture several times a day, then a cabbage leaf is applied to remove pus. For maximum effect, the product is used for several weeks.
2. Fresh calendula flowers are tightly folded into a glass container, poured with melted butter, insisted for 12 hours. After that, place in the oven for 48 hours (at a temperature of 70 degrees). The medicine is stored in a container with a sealed lid in a dark place. The resulting agent lubricates the inlet of the fistula.
3. 200 g of finely chopped onion is poured with hot pork fat, heated in a pan until the onion darkens. The resulting mixture is infused for 6 hours, shaking occasionally. A fistula is treated with such an ointment, alternating with other means.
4. Prepare a tincture of dandelion flowers in triple cologne to cure external fistulas. The resulting liquid is instilled with a pipette directly into the fistula channel to achieve the maximum therapeutic effect.

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Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

Discuss

Fistula - what is it and causes, symptoms, treatment and prevention

A fistula of the rectum is often formed as a result of paraproctitis, as well as other diseases of the intestinal tract. Often a person may not notice the first signs of the disease or write them off for other conditions of the body.

This behavior often causes the anal fistula to grow, fester, and the tissue around it becomes inflamed.

It is impossible to cure such a disease on its own and you will have to resort to surgery.

Characteristics of fistulas

Fistulas are channels that run from the intestines to the anus, and go outside, or penetrate into neighboring internal organs. Such channels are often filled with pus and infiltrate, feces and microbes enter them. Often the inflammatory process affects neighboring tissues and other parts of the intestine. Fistulas of the rectum are classified according to several parameters.

The passage is straight, has no branches, does not form scar tissue, and there is no pus or infiltrate. Any rectal fistula goes through several stages of development before it becomes a difficult difficult problem to resolve.

There are such stages of development:

1. The opening at the exit of the fistula is surrounded by scar tissue that continues to grow. There is still no pus and infiltration.
2. The scar tissue comes off, but abscesses appear.
3. The fistulous canal has branches, a lot of abscesses. In the fistula, the presence of an infiltrate is noted.

Anorectal fistulas are a big problem for people, but if left untreated, complications can become much more of a nuisance. Therefore, it is important to diagnose a fistula of the rectum in a timely manner, best of all at the initial stage of development, then it will be better treated.

Causes of fistulas of the rectum

Anorectal or pararectal fistula most often appears after the transferred and untreated paraproctitis. But there are also other causes of fistulas of the rectum, namely:

• a surgical error when paraproctitis is treated, but the affected areas are not completely removed during the operation;
• bowel disease (Crohn's disease, diverticulitis, anal fissures, hemorrhoids);
• complications after the hemorrhoid is removed - muscle fibers are sutured;
• rectal injuries received independently or during diagnostic medical procedures;
• chlamydia, syphilis;
• intestinal tuberculosis;
• malignant neoplasms in the intestines, especially in the rectum;
• postpartum trauma in women.

Often the problem is aggravated by long-term chronic constipation, when the fistula only appears, the feces, which cannot leave the body in a timely manner, begin to clog this passage and release toxins. This contributes to a more active development of the fistula, as well as aggravating the complexity of the process itself.

Symptoms

The symptoms of this pathology are often so pronounced that it is simply impossible to confuse them with signs of other diseases. Patients complain about:

• pain in the lower abdomen, as well as in the rectum, pain in the anus intensifies during the act of defecation;
• discharge from the exit of the fistula of pus, which is noticeable on clothes and underwear;
• deterioration in the condition of existing anal fissures or the formation of new ones;
• weakness and decreased performance;
• the presence in the feces of impurities of blood and pus, a characteristic non-specific odor;
• irritation of the anus with discharge from the fistula, the appearance of a rash on the skin in the anal and perianal region;
• increase in body temperature;
• pararectal fistulas can lead to inflammation of the female genital organs, which will be accompanied by pain and discharge of pus from the vagina;
• problems with sexual life in men.

Patients rarely endure such symptoms for a long time, so they try to seek help from a proctologist for excision of the fistula in order to get rid of the tormenting problem, as well as eliminate other signs of rectal disease.

Diagnostics

Diagnosing a fistula of the rectum is quite simple even at the time of collecting anamnesis and digital examination of the intestine. However, to confirm the diagnosis, as well as to establish the causes of the formation of passages and the detection of concomitant diseases, doctors use additional diagnostic measures.

These include:

1. Sigmoidoscopy - examination with a probe of the rectal area, you can learn more about what it is.
2. Colonoscopy - examination of the rectum and large intestine with a probe with the possibility of taking material for a biopsy.
3. Ultrasonography is an examination of the rectum using an ultrasound machine, when the tube itself is inserted into the intestine and ultrasound is delivered from the inside.
4. Staining of the anus - with the help of a dye injected into the rectum, a fistula can be detected by observing the filling and distribution of the substance through the intestines.
5. Fistulography - an x-ray of the rectum is taken using a contrast agent.
6. - allows you to find out the performance of the sphincter of the anus.
7. Microbiological examination of discharge from the rectum or directly from the fistula itself - allows you to establish the presence of a bacterial infection associated with the disease.
8. CT is performed if the fistula has given complications to neighboring organs.

These diagnostic methods allow you to establish an accurate diagnosis, as well as identify the cause of the fistula, if there are extraneous bowel diseases. It is also necessary for the doctor to tell how to treat not only the fistula itself, but also its other complications or concomitant diseases.

Treatment

It is impossible to cure a fistula of the rectum at home with folk remedies. Even medicines do not always give a positive result. Whether the fistula can pass or take place? This is unlikely, it is impossible to hope for luck here, since the consequences of this pathology, if left untreated, can be fatal for a person. The main treatment for a fistula is surgery.

Treatment without surgery is in one option - pouring fibrin glue into the fistulous passage until it is completely filled, followed by suturing both openings of the intestinal fistula. However, such treatment does not guarantee complete recovery and the absence of re-formation of fistulas, especially if the original cause of the disease is not eliminated.

Operation

Surgical treatment consists in excision of the fistula, as well as drainage of abscesses. During excision, it is important not to touch healthy tissues and be extremely clear - limit yourself to the affected area. The operation to remove the fistula of the rectum takes place under general anesthesia and is painless for the patient, which cannot be said about the postoperative period.

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It is also possible to carry out such an operation with a laser. This will take less time and reduce the risk of infection, the patient will be able to return to their normal lifestyle in the very next few days. However, this operation is more expensive.

The postoperative period is an important part in the process of recovery and prevention of relapses.

At this point, you need to follow the rules:

• in the first three days there was no defecation, so the patient can hardly eat, you can only drink decoctions and water, glucose is administered intravenously. This is done to prevent injury to the closed canal by stool.
• food was further liquid and in small portions, so that the feces were soft and did not injure the intestines;
• the patient complied with bed rest, did not lift weights;
• dressings were regularly performed, you can use an ointment with an anesthetic effect to relieve pain after surgery.

Treatment takes about two weeks, so that there is no recurrence of the disease, you need to establish what causes the fistula in this case, and try to avoid this factor, or treat the existing disease that provokes this phenomenon.

Complications

The fistula of the rectum is very dangerous for its complications. If purulent contents enter the abdominal cavity, peritonitis may develop, which is often fatal. Also, due to the fistula, bleeding is possible, which can lead to anemia. Intoxication of the body with stagnant feces, when the fistula interferes with its exit, can adversely affect the general well-being of the patient, as well as the functions of other organs.

If scars are formed in large numbers, this can threaten the disruption of the sphincter, which will further lead to fecal incontinence. Also, in certain cases, a fistula can cause a malignant neoplasm.

So that the disease does not bring significant harm to the body, it must be treated immediately, without delay. A fistula of the rectum has a good chance of a complete remission without a return of the disease. If the operation is carried out in time, then the person retains full working capacity and normal health.

Video

Or a fistula (from the Latin fistula - tube) - a pathological channel connecting the focus of the disease (abscess, tumor) with the surface or some body cavity. Liquid secretions from the affected organ or tissue (urine, pus, intestinal, gastric contents or bile) constantly pass through them, so self-healing often becomes very difficult.

Fistulas can be congenital, acquired and artificial. Congenital are formed in connection with malformations. These include median and lateral fistulas of the neck, fistulas of the navel. Acquired fistulas occur as a result of purulent diseases - osteomyelitis, tuberculosis, or trauma to organs and tissues. Sometimes fistulas, for therapeutic purposes, are created artificially.

Types of fistulas

According to their location, fistulas can be internal or external, single or multiple.

Depending on the location, fistulas are purulent, urinary, gastric, salivary, bile, on the small and large intestines.

Purulent the fistula is located on the surface and is intended for the outflow of purulent discharge from the focus of the inflammatory process. In rare cases, the inflammation goes away on its own, then the suppuration stops and the fistula tightens, but then reopens.

Uric a fistula occurs on the ureters, bladder and urethra due to trauma, sometimes it is created artificially.

Gastric a fistula on the stomach is specially created artificially for enteral feeding.

in the small intestine occurs due to complications after surgery or injury, with proper treatment, such a fistula heals quite quickly.

on the large intestine arises as a result of an injury, or it is created artificially, can heal on its own. When passing feces through the fistula, the skin is injured, so special ointments must be used.

biliary fistula occurs as a complication after surgery, this fistula has bad consequences, so they need to be treated immediately.

Salivary fistula occurs as a result of inflammatory processes in the area of ​​\u200b\u200bthe area of ​​​​the cheeks, ear or neck, in this case saliva is released.

Causes

Inflammation of various nature (with the presence of a cavity with an infection), trauma with damage to the organ wall, chronic periodontitis, suppuration of the sutures.

Symptoms

Weakness, fever, aching pain (can be very severe), discharge of pus with an unpleasant odor, itching, redness, swelling in the area in the area of ​​​​the fistula.

Treatment with folk remedies

- Make candles from potatoes and when they dry a little, they must be held in a menovazine. And after the enema, insert them into the anus. Repeat the procedure every other day. A week later, potato candles should be processed already in the infusion of celandine and also put every other day. So alternate: a week with a candle with menovazine, a week with celandine (fistula in the large intestine).

— Tear off 12 leaves from the bottom of an aloe flower of 2-3 years of age, rinse well in boiled water, finely chop and pour into a liter jar. Pour aloe with fresh honey so that it completely covers it, close and put in a dark place for 8 days, shake well every day. Strain and take the infusion 1 hour spoon 3 times a day before meals. (Ligature fistula).

- Take mummy once a day on an empty stomach for 25-28 days (course of treatment). Dilute the mummy in 2-3 tablespoons of boiled water, and preferably in milk. With advanced disease, repeat the course after 10 days. The required amount of mummy intake per day depends on the person's weight: up to 70 kg. - 0.2g, 80kg - 0.3g, 90kg - 0.3-0.4g, over 90kg - 0.4-0.5g. And for the best result, at the same time as taking the mummy inside, apply the mummy and externally - rub the affected areas. To do this, dissolve 3 g of mummy in 100 ml of boiled water.

— Miracle ointment. Pour 1 glass of lean (sunflower) or olive oil into an enameled bowl, dip in natural wax (church candles will not work) the size of a matchbox. Put on a small fire to melt the wax. Take half of the yolk from a hard-boiled egg, grind it and send it in small pieces to the boiling mixture. The oil immediately begins to foam, so you need to be careful, quickly remove the pan from the heat - let it rage to the side, but at the same time you need to stir constantly. Put on the stove and send another piece of yolk to the brew, and so on, until the whole half of the yolk runs out. Then strain the mixture through a nylon cloth. Store the ointment in the refrigerator, warm it up a little before use. (Purulent otitis, all boils, fibroma, ulcer, gangrene, burns).

— All take 50g. Mix rosin, natural wax and honey, unsalted lard (melted lard), laundry soap and vegetable oil (sunflower). Grind all components and boil. When the mass cools down a little, add chopped onions, aloe and garlic. Put on the stove, let it boil and leave, wrapped, for 2 hours. Strain and lubricate sore spots, heat the ointment in a water bath before use. (Gangrene, abscesses, boils, fistulas, bitch udders).

— Take 1 liter of vegetable oil, 30 ml of fresh juice of one whole stem and 100 ml of purified kerosene. Mix all components thoroughly and infuse in a dark, cool place for 7 days, shaking occasionally. Soak a sterile napkin with the resulting mixture and apply to the sore spot. Change the bandage 2 times a day for 2 weeks. Shake the mixture constantly before each use. (Gangrene, purulent wounds, ulcers, boils, fistulas, bough udders).

- Bring 2 liters to a boil, throw in the milk peeled 2 medium-sized onions and 4 cloves of garlic. Boil for 2 minutes, cool a little, and sit on it, wrapping a blanket around. Sit while the milk is hot. Such procedures are carried out daily until recovery. You can use the same milk each time.

- Take equal amounts of beeswax, mutton fat, spruce resin, honey and finely chopped garlic. Mix all the ingredients, put in a pan and, stirring constantly, melt over low heat. Apply a sterile gauze napkin soaked in this mixture to the surface of a boil, abscess, fistula or purulent wound. Such « plaster "quickly hardens, draws out pus well, cleans and disinfects wounds.

- Take 5 handfuls of sifted ash per 7 liters of water, boil for half an hour, stand and strain. Take a bath of warm lye for 20-30 minutes, you can simply wash the wound with this solution. Small filamentous worms, the culprits of the disease, should go into the water. Depending on the severity of the disease, this must be done several times, but sometimes 2-3 times are enough for the wound to clear, heal and the fistula no longer appears.

- Take 100g each - spruce resin, pork internal fat and beeswax. Mix, boil and cool. Apply a bandage with the resulting ointment to the treated wound. (Ulcers, burns, fistulas).

— Grate half a piece of laundry soap and mince 4 onions. Melt 50 g of unsalted butter in a saucepan over low heat, add onion to it and simmer for 10-15 minutes. Then add 300 g of interior lard, grated soap and constantly stir over low heat until a homogeneous mass is obtained. Put 2 church candles or 50g of pure wax and boil for another 5 minutes over low heat. Strain and put the mass in a clean sterilized dish and store in the refrigerator. Before use, the ointment can be warmed up. (Fistulas, purulent wounds).

Fistula - what is it? You will find the answer to the question posed in the materials of the presented article. In addition, we will tell you about why such a pathological condition occurs, as well as what symptoms it is accompanied by and how you can get rid of it.

General information

Fistula - what is this deviation? In medical practice, such a pathological phenomenon is often called a fistula. This word is derived from the Latin "fistula" and literally means "tube". In other words, a fistula is a kind of channel that connects a tumor or abscess to the surface or two cavities (two organs) to each other.

Appearance

Fistula - what is this pathological phenomenon, what does it look like? As a rule, such a fistula looks like a rather narrow canal, which is lined with an epithelial layer and is accompanied by characteristic secretions.

Main reasons

Why does a fistula develop? Reasons for this deviation include the following:

• After the cessation of any inflammation, pus usually comes out. Moreover, the channel through which it flows out heals painlessly in the future. However, in some cases (for example, if the inflammatory process has not been completely eliminated), there continues to be a cavity with infection in the depths of the tissues (sometimes even with a dead bone area), and therefore the “tube” does not grow together, but forms a purulent fistula.
• Fistulas can arise from the roots of the tooth (in chronic periodontitis), passing through the gum and jaw.
• If, after the blind, fragments of bullets and bones were not removed in time, then suppuration also forms next to them, which leads to the development of fistulas.
• This deviation is often formed after surgical operations with suppuration of sutures next to ligatures (that is, threads used to tie internal tissues, blood vessels, etc.). In this case, there is a ligature fistula.

Types of fistulas by location

Before proceeding with the treatment of such a deviation, its type should be determined. This is not difficult to do, since this classification depends primarily on the location:

• Gastric fistula. This pathology most often occurs after surgical operations (for example, after resection of the main digestive organ).
• Rectal fistula.
• Fistula anorectal. Such a deviation is characterized by a pathological canal leading from the anus (or rectum) to the skin.
• Fistula pararectal. Runs outward from the anal crypt to the skin.
• Rectovaginal fistula. With this disease, the rectovaginal septum is damaged.
• Duodenal, or so-called intestinal fistulas. This is the external canal coming from the duodenum.
• Fistula bronchial. Such a deviation is accompanied by pathological communication of the lumen of the bronchus with the pleural cavity.

Types of fistulas due to the appearance

Absolutely any fistula (photos of these deviations are presented in this article) can be classified as follows:

• Acquired. In other words, such a phenomenon occurs as a result of suppuration (for example, a fistula of a tooth with either serious diseases such as osteomyelitis or tuberculosis.
• Congenital. In this case, fistulas arise from malformations (on the navel, neck, etc.)
• Created artificially. Such deviations are formed after surgical intervention (for example, ligature fistula).

Types of fistulas by contact with the environment

In this case, such a pathological phenomenon may be:

• External, that is, go directly to the skin (for example, a fistula of the rectum).
• Internal, that is, not communicate with the external environment in any way, but connect only adjacent cavities (for example, bronchoesophageal fistula).

Types of fistulas according to the nature of the secret that stands out from them

These fistulas include:

• purulent;
• mucous membranes;
• bile;
• urinary;
• feces, etc.

The main symptoms of the disease

The clinical picture of such a pathology depends, first of all, on the location of the fistulas and the cause of their appearance.

Thus, the main symptom of this disease (external) is a hole in the skin, from which fluid is released. By the way, the appearance of a fistula may be preceded by either trauma to this area, or inflammation of nearby tissues and organs, or surgery.

As for internal fistulas, most often they appear as a result of complications of chronic or acute diseases. For example, bile is often formed due to obstruction of the ducts by a stone. In this case, the symptoms of the deviation depend on the amount of bile that is secreted into the abdominal cavity. So, the patient may feel severe pain and pronounced disorders of the digestive tract.

Bronchoesophageal fistulas are often complicated by food entering the tracheobronchial tree. It is this fact that leads to the development of aspiration pneumonia or bronchitis with the corresponding symptoms.

A fistula of the rectum can be identified by the following symptoms:

• The presence of a barely noticeable hole in the anus (on the skin). In this case, the patient may experience copious discharge of pus, and therefore he is forced to constantly wear a pad and take a shower regularly.
• Aching pain in the anus. As a rule, such sensations are most intense during a bowel movement, and after they noticeably subside.

A fistula on the gum is determined by such signs as:

• severe tooth mobility;
• toothache that gets worse when touched
• purulent discharge.

Diagnostic methods

If you observe at least one of the above signs in yourself, then you need to immediately consult a doctor for a correct diagnosis. It should be noted that specialists do not have any special difficulties in diagnosing such a deviation. After all, it is based on collecting an anamnesis, studying the characteristic complaints of patients, the type of fistula, analyzing the composition and amount of fluid released, as well as changing the functioning of the affected organs.

To clarify the direction and length of the fistulous canal, as well as its direct connection with the focus, probing and radiography are often used in conjunction with the introduction of a contrast agent into the passage.

By the way, you can clarify the diagnosis of "gastric fistula" with the help of studies for the presence of hydrochloric acid. If it is present in the channel, then this indicates the gastric location of the fistula. But for the urinary fistula, the presence of uric acid salts is characteristic.

It should be especially noted that external fistulas are much easier to diagnose than internal ones. After all, they have a characteristic hole that can be seen by a specialist with the naked eye. With regard to internal fistulas, they should be detected not only by the existing symptoms and complaints of the patient, but also with the help of diagnostic methods such as ultrasound, radiography and endoscopy.

Fistula: treatment with official medicine

Therapy of patients with external fistulas is based on:

• local treatment;
• general therapeutic;
• operational.

By local therapy is meant the treatment of the formed wound, as well as the protection of the tissues surrounding it from the effects of the fluid that is released from the canal. For example, if the fistula is on the leg, abdomen, etc., then the purulent area is treated with various means (ointments, pastes and powders). They are applied at the outer opening of the canal, thereby preventing skin contact with pus, mucus, etc.

In addition, chemical agents can be used that exclude irritation of external tissues by neutralizing secretions from the fistulous passage. For this, it is recommended to use enzymes (for example, Gordoks, Kontrykal, etc.).

Mechanical methods of protecting the skin are primarily aimed at reducing or completely stopping the discharge from the canal with the help of special devices.

For the general treatment of purulent and other fistulas, they are constantly washed with an antiseptic solution.

Tubular granulating passages quite often close on their own after the elimination of the causes of their occurrence (for example, removal of bone sequester, ligatures, etc.). But labial fistulas never go away on their own. For the treatment of such deviations, only surgical intervention is used to excise them, sew up external openings, or resect the affected organ.

It should also be noted that in some cases surgeons form fistulas artificially specifically so that the patient can eat, or in order to remove the accumulated secret from any internal organ. These channels can be either permanent or temporary. After the patient's condition improves, the temporary channels are closed surgically.

In addition to external, internal fistulas (interorganic) are also artificially created. As a rule, they are imposed either for a long time, or for life.

Treatment of a fistula with folk remedies

Of course, the treatment of such a deviation requires a mandatory consultation with an experienced doctor. Indeed, with untimely and incorrect therapy, a fistula can lead to serious complications that can endanger a person's life.

But, despite this likelihood, adherents of alternative medicine still use numerous folk methods to close the formed fistulas. Let's consider some of them in more detail.

Treatment of ligature fistula with aloe

To prepare the medicinal product, it is necessary to take 10-12 fleshy arrows from the presented plant, and then wash them in warm boiled water. Next, aloe needs to be finely chopped and placed in a liter jar. Pour 300 g of any honey into the container, cover loosely and put in a dark place for 7-10 days. In this case, after 4-5 days, it is desirable to mix the mass well. In conclusion, the tincture needs to be filtered several times and taken in a dessert spoon three times a day.

Ointment for external fistulas

Such an ointment serves well for the healing and treatment of vaginal fistulas, and for this we need water pepper grass, oak bark, lard and toad flowers. All imposed plants must be crushed, and then placed in a container and immediately poured with melted lard. In this case, the ratio of fat and herbs should be one to two.

After the done actions, it is necessary to put the filled dishes in the oven and turn on a slow fire. It is desirable to heat the ointment for at least 7-11 hours. In conclusion, the drug must be cooled at room temperature. The method of treatment with such an ointment is quite simple. To do this, you need to make a cotton swab, generously lubricate it with a remedy, and then attach it to the fistulous opening. It is advisable to change the bandages every five hours.

Decoctions from external fistulas

Infusions and decoctions of medicinal chamomile are used only externally - for washing holes. To prepare them, you need to take 1 large spoonful of dried flowers, brew them with one glass of boiling water, and then insist for 60 minutes and filter.

Also, decoctions made from calendula are used to wash fistulas and create compresses.

Prevention

Now you know how to treat a fistula, what it is, why it occurs. Prevention of acquired channels should include the prevention of infectious diseases. In addition, it is required to strictly observe the rules of asepsis during surgical interventions.

As for the prevention of congenital fistulas, this is impossible, since the disease occurs in the first trimester of pregnancy.

What is a fistula (fistula)? This is a pathologically formed channel (tube) connecting a hollow organ or tumor with the environment or two organs (or cavities) between themselves. In the cavity of such a fistula, there is always a secret or exudate, which maintains a constant inflammation of the fistula. Spontaneous cure of this pathology is impossible, a favorable outcome (complete recovery) is possible only with surgical intervention.

The term "anal fistula" is used to denote a pathologically formed passage connecting the rectum and the hole formed on the skin in the anal area. Such a fistula passes through the pararectal tissue and opens with one or more holes. The disease is complicated by the fact that the process is spontaneously inflamed by fecal masses protruding into the cavity of the fistula and is located inside the adrectal tissue, which is easily susceptible to infection. Methods of conservative elimination of pathology rarely bring results when paraproctitis occurs, and even more so, the formation of a fistula requires an appeal to a surgeon - a proctologist.

Causes of the disease

To understand the pathophysiology of the process, it is necessary to determine from what the fistula appears. The reasons for the formation of a pathological message can be specific - as a result of certain diseases:

• Crohn's disease;
• tuberculosis infection;
• actinomycosis;
• malignant and benign formations of the rectum;
• tissue injury;
• unsuccessful surgical interventions for various diseases.

The most common reason for the formation of fistulas is non-specific factors, namely (inflammation in one of the crypts of the anal canal).

The most common cause of anal fistula formation is inflammation around the intestinal tissue.

Important! With self-treatment of acute paraproctitis, there is a high probability of fistula formation after spontaneous opening of the abscess.

Are rectal fistulas dangerous?

In addition to unpleasant symptoms, a fistula of the rectum creates a risk of developing the following complications that pose a threat to the health and life of the patient:

1. blood poisoning (sepsis);
2. the formation of scars in the fiber along the pathological canal, which leads to spontaneous release of feces and intestinal gases;
3. the formation of scars along the walls of the anus, which is expressed in the soreness of the act of defecation and minor bleeding with each stool;
4. fistulas of the rectum can degenerate into an oncological disease (rectal cancer).

Even without the development of serious complications, rectal fistulas worsen the quality of life of the patient, making normal social life impossible due to the constant leakage of feces, accompanied by a characteristic odor.

Classification

The fistula of the anus has its own characteristics during the course of the disease, depending on the location, the number of holes and branches, the presence of pathological processes along the canal and the stage of inflammation.

Types of fistulas depending on localization

The modern classification describes fistulas taking into account the factors listed above.

According to the location of the fistula openings:

• a complete fistula originates in the rectum and ends with a skin outlet in the anus. The fistula can be simple (1 inlet and 1 outlet connected by a straight tube) and complex (has 2 or more inlets, forms an extensive network of tubes in the intestinal tissue and ends with one or more "holes" in the anus);
• incomplete is characterized by an incomplete breakthrough of the abscess, a hole from the rectum with the formation of a blind canal in the adrectal tissue. This condition is transient and, with further inflammation, it will break either outward or into the intestinal cavity;
• internal fistula is characterized by the presence of an inlet and outlet in the cavity of the rectum, the channel between the holes is located in the intestinal tissue.

By localization relative to the sphincter:

1. Intrasphincteric move. Such a fistula of the rectum is not treated by conservative methods, it is located along the edge of the anus and has a direct course;
2. transsphincteric fistula has many passages, pockets and a tortuous course. Leads to the formation of scars along the "tube" near the intestinal space, passes through the muscles of the sphincter, deforming it, which is accompanied by the formation of incontinence;
3. extrasphincteric. It originates above the sphincter, without affecting its muscles, and exits with one or more openings at the anus.

Advice. In the event of acute paraproctitis, you should immediately contact a proctologist surgeon for the purpose of excision and full treatment. In the absence of timely assistance during paraproctitis, a fistula forms, which significantly worsens the prognosis.

Symptoms

The fistula of the rectum is manifested by the following symptoms:

• a feeling of itching and discomfort in the anal area persist for a long time;
• the patient is disturbed by the discharge of pus or ichor, accompanied by a fetid odor. Allocations are found on underwear and skin. Constant washing and anti-inflammatory sitz baths, together with the wearing of protective pads, only slightly reduce unpleasant manifestations. A person cannot lead a normal life and work under normal conditions;
• there is pain in the anus when exerting, during a chair, coughing or sitting;
• sometimes there is an increase in body temperature.

Important. The course of the disease is undulating and has periods of remission and exacerbation, the longer the process remains unresolved, there a large area around the intestinal tissue is involved in the pathological process.

Exacerbation of the disease and the formation of fresh foci of infection is accompanied by common signs of intoxication: decreased performance, weakness, drowsiness against the background of insomnia, fever.

When forming a fistula of the rectum, the symptoms in men do not differ from those in women, however, in most cases, there is a decrease in potency, followed by the formation of erectile dysfunction.

Treatment

After making a diagnosis, the doctor chooses the tactics of managing the patient. Treatment of a fistula will depend on the form of the disease and the degree of its development, the presence of complications and concomitant diseases of the body. Given the need for surgical intervention in a serious condition of the patient or serious inflammatory processes in the body, drug therapy is prescribed to eliminate these factors. After the life-threatening situation is eliminated, an operation is scheduled.

How to treat a fistula of the rectum is decided by the doctor individually with each patient, not only the condition and shape of the fistula, but also the surgeon's capabilities affect the adoption of a particular decision. During an exacerbation, local treatment (baths, ointments, powders) is possible, which consists in protecting the skin from the negative effects of secretions and the use of antibiotics to relieve the inflammatory process. After stopping the acute course, surgical treatment is performed to close the formed fistula.

Fistulectomy

This technique is used for primary fistulas, mainly subcutaneous and intersphincteric.

The fistulectomy technique is as follows: a surgical probe is inserted into the fistula canal through an internal or external hole, after which the specialist dissects the tissues throughout the canal in order to fuse the tissues. This method usually does not violate the function of the sphincter, except for severe and neglected cases.

The granulation tissue lining the canal is removed with a surgical curette. Complete excision of the edges of the canal allows you to prevent recurrence of the pathology.

Surgical treatment of rectal fistula is the most effective method of treatment

Ligature method

Complicated rectal fistula involves a more complex operation, used independently or in conjunction with fistulectomy.

A ligature (draining material, it can be a thin tube or a silk thread) is inserted into the lumen of the canal and carried out throughout the fistula. The ligature allows you to navigate with the volume of the affected tissue. The introduction of drainage allows you to speed up the regeneration process due to the outflow of exudate and control over the closure of the inlet and outlet.

Indication for choosing a ligature method:

• complex and branched fistulas;
• multiple formation of fistulas (2 or more);
• relapse after fistulectomy;
• decrease in sphincter tone, determined before surgery;
• impaired immunity.

Movement of the skin flap

The method is chosen for high fistulas and frequent recurrences after excision. With this type of operation, the entire affected surface is excised with further mixing of the flap onto the affected surface. The method is not valid for acute inflammation and some diseases of the internal organs.

Treatment with fibrin glue

Laser processing

The fistula of the anus undergoes laser treatment, treatment is possible with simple, uncomplicated processes. The effectiveness of this procedure exceeds 80% of the manipulations performed, a complete cure without relapses and all kinds of complications.

Important. Treatment of fistula at home using traditional medicine methods is not acceptable. The longer the process is left without the attention of a specialist, the more difficult it will be to get rid of the pathological process.

Postoperative period

After excision of the fistula of the rectum, the patient requires medical supervision and additional treatment throughout the postoperative period.

In the early postoperative period (2-4 days), analgesics are prescribed to reduce pain.

About a week after the operation, it is necessary to follow a special diet (the first days are liquid food, followed by the introduction of more serious meals).

Until the wound heals, sitz anti-inflammatory baths should be taken at least 3 times a day, additionally after each act of defecation.

If you experience signs of inflammation, you should contact your doctor, namely:

• hyperthermia (an increase in body temperature indicates the onset of inflammation);
• difficulty emptying the bowels or bladder;
• the appearance of incontinence of gases or feces;
• the appearance and intensification of pain in the perineum 3-4 days after surgery;
• the occurrence of pain in the abdomen;
• the appearance of purulent discharge.

Possible complications in the early and late postoperative period.