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Fistula Treatment in Delhi: Importance, Options, Care, and Risks

Treating a fistula in Delhi is crucial to prevent complications such as abscess formation, infection, and incontinence. Fistulas come in various types, including anal, enterocutaneous, and vesicovaginal, and each requires specific management strategies.

Anal fistulas, which are common, often require surgical intervention to restore normal function and alleviate symptoms. Timely and effective treatment is essential for preventing long-term health issues.

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What is Fistula?

A fistula is an abnormal connection or passage between two organs, tissues, or vessels that are not normally connected. It can develop due to infections, injuries, surgeries, or underlying conditions like Crohn’s disease. Fistulas can occur in different body parts, such as the digestive tract, the urinary system, or between blood vessels. Common types include anal, arteriovenous, and obstetric fistulas. They can cause symptoms like pain, swelling, discharge, or infections. Treatment depends on the location and severity and may include medications, drainage, or surgery. If left untreated, a fistula can lead to complications like chronic infections or organ damage.

Importance of Fistula Treatment

Why Treatment is Necessary?

Treating a fistula in Delhi is vital to prevent severe complications, which can significantly affect your health.

Preventing Complications: Untreated fistulas can lead to recurring abscesses, chronic pain, and systemic infections, all of which can complicate your condition.

Restoring Normal Function: Treatment helps restore normal bowel function and prevents complications like anal stricture, which can have long-term effects.

When to See a Doctor for Fistula Treatment in Delhi

Recognizing the symptoms of a fistula in Delhi early is crucial for effective treatment.

  • Warning Signs: Persistent pain, swelling, and discharge of pus or blood should prompt immediate medical attention.
  • Seeking Specialist Care: Consulting a specialist, such as a colorectal surgeon, is advisable for personalised advice and optimal treatment outcomes.

Different Types of Fistula and Their Treatment Options

Fistulas can be classified based on their location and cause. Understanding the different types of fistulas is crucial in determining the appropriate treatment method for each case.

  • Anal Fistulas

Cause: Often caused by infections in the anal glands or rectal abscesses.

Symptoms: Pain, swelling, and discharge around the anus.

  • Treatment Options:
  • Non-Surgical: Medications and antibiotics to manage infection.
  • Surgical: Fistulotomy or seton placement are common surgical procedures for anal fistulas.
    • Enterocutaneous Fistulas

    Cause: These fistulas form between the intestine and the skin, often as a result of abdominal surgery or trauma.

    Symptoms: Leakage of intestinal fluids through the skin, abdominal pain, and fever.

    • Treatment Options:
  • Non-Surgical: Nutritional support, wound care, and antibiotics to prevent infection.
  • Surgical: Surgical closure of the fistula tract may be required, especially if it is persistent or complicated.
    • Vesicovaginal Fistulas

    Cause: These fistulas form between the bladder and vagina, often as a result of childbirth, pelvic surgery, or cancer treatment.

    Symptoms: Uncontrolled leakage of urine from the vagina, irritation, and frequent urinary infections.

    • Treatment Options:
  • Non-Surgical: Conservative management with urinary diversion or catheterization in some cases.
  • Surgical: Surgical repair is often necessary to close the fistula and restore normal bladder function.
    • Aortoesophageal Fistulas

    Cause: A rare but life-threatening condition where a fistula forms between the aorta and esophagus, typically due to trauma, infection, or cancer.

    Symptoms: Severe bleeding, chest pain, difficulty swallowing, and coughing up blood.

    • Treatment Options:
  • Non-Surgical:Stent placement to control bleeding and reduce symptoms.
  • Surgical: Emergency surgery to close the fistula and control bleeding, which is often required due to the severity of the condition.
  • What is Anal Fistula?

    An anal fistula is a small tunnel that forms between the skin near the anus and the end of the digestive tract. It usually develops due to an infection in the area, leading to the formation of a pus-filled lump called an abscess.

    In most cases, the abscess either drains on its own or is treated through a surgical procedure. When the pus is removed, it leaves behind a narrow passage under the skin, which is known as a fistula.

    Anal fistulas can cause discomfort, skin irritation, and other unpleasant symptoms. Since they do not heal on their own, surgery is usually required to close the fistula and prevent further infections or complications.

    Signs and Symptoms of Anal Fistula

    Following are some common symptoms of anal fistula:

  • Skin irritation around or near the anus.
  • Persistent and throbbing pain, which worsens as you sit down, pass stool, cough, or move around.
  • Smelly discharge from the anus.
  • Passing pus while passing stool.
  • Inflammation and redness around the anus, as well as fever (high temperature) when you have got an abscess.
  • Difficulty to control bowel movements in some cases.
  • You might even notice symptoms such as:

    • Bleeding while passing stool.
    • Painful urination or bowel movements.
    • A foul-smelling fluid discharge oozed from the anal hole.

    The end of the fistula may be visible in the form of a hole near the skin around the anus, but it is difficult to see it yourself.

    If you notice or experience any of these signs or symptoms lately, you must seek medical help immediately. Do consult an experienced specialist to get the best treatment to cure this condition.

    Types of Anal Fistula

    The different types of anal fistulas are categorized as per their location, such as:

    • Intersphincteric fistula: In this type, the tract starts within the space between the external and internal sphincter muscles, as well as open near the anal opening.
    • Transphincteric fistula: The tract starts within the space between external and internal sphincter muscles or behind the anus. It further crosses through the external sphincter and further opens outside the anal opening.
    • Fistula: In this type, the tract starts in a space between internal and external sphincter muscles. It then turns upward to a position just above the puborectalis muscle to cross this muscle. It also extends downward between the levator ani and puborectalis muscle and then opens outside the anus.
    • Extrasphincteric fistula: In this type, the tract starts at the sigmoid colon or rectum and then extends downward. It passes via the levator ani muscle to open a few inches near the anus.

    Dr. Sanjeev Kumar Gupta

    MBBS, MS - General Surgery, Laparoscopic Surgeon, General Surgeon

    • Laparoscopic Surgeon, General Surgeon
    • 27+ Years Experience

    Anal Fistula Treatment Center in Delhi

    SCI Hospital's skilled medical specialists have extensive experience in treating colon and rectal conditions, gastroenterology issues, and infectious diseases, including fistulas. Our team works collaboratively to assess and determine the most effective procedures for anal fistula treatment.

    For patients dealing with anal fistulas or other medical conditions, SCI Healthcare experts coordinate with their primary care doctors to develop a personalized treatment plan.

    With all specialists available in one place, patient care is thoroughly discussed, ensuring timely diagnosis and treatment. Additionally, results are delivered promptly, and appointments are scheduled efficiently with our highly specialized team.

    Non-Surgical Treatment Options for Fistula

    When it comes to managing fistulas, non-surgical treatments can be effective in alleviating symptoms and preventing the condition from worsening. These options are particularly beneficial for patients who may not be candidates for surgery or prefer less invasive methods.

    Surgical Treatment Options for Fistula

    When non-surgical treatments are insufficient, surgical intervention becomes necessary to effectively manage and treat fistulas. Various surgical options are available, each with its own approach, benefits, and considerations:

    Fistulotomy

  • Procedure Details: Fistulotomy is the most common surgical procedure for treating anal fistulas. It involves cutting open the entire length of the fistula tract to allow it to heal from the inside out. This procedure is typically performed as an outpatient surgery, meaning patients can go home the same day.
  • Recovery Time: Recovery usually takes a few weeks, during which patients need to follow specific post-operative care instructions to ensure proper healing.
  • Success Rates: Fistulotomy has high success rates, especially for simple fistulas, with healing rates reported as high as 98.6% in some studies.
  • Seton Placement

  • Purpose and Use: A seton is a surgical thread placed through the fistula tract to keep it open and allow drainage while preventing premature closure. It is often used for complex fistulas where a fistulotomy might risk incontinence.
  • Recovery Expectations: The seton remains in place for several weeks or months, depending on the complexity of the fistula, and may require periodic tightening or adjustment.
  • Advancement Flap Procedure

  • Procedure Explanation: This technique involves covering the internal opening of the fistula with a flap of healthy tissue, typically taken from the rectal wall. It is used for complex fistulas where preserving sphincter function is crucial.
  • Benefits and Risks: While this procedure can be effective, it carries a risk of recurrence and requires careful postoperative monitoring to ensure successful healing.
  • LIFT Procedure (Ligation of Intersphincteric Fistula Tract)

  • Overview: The LIFT procedure is a newer surgical technique that involves accessing the fistula tract between the sphincter muscles and ligating (tying off) the tract to close it. This method minimises damage to the sphincter muscles and is designed to preserve continence.
  • Success Rate: It has shown promising results with good success rates, particularly in complex fistulas.
  • Lifestyle and Dietary Changes Required for Fistula

    Adopting certain lifestyle and dietary modifications can play a significant role in managing fistula symptoms:

    • High-Fiber Diet: Consuming a diet rich in fibre helps regulate bowel movements and prevent constipation, which can exacerbate fistula symptoms. Foods such as fruits, vegetables, whole grains, and legumes are excellent sources of fibre.
    • Hydration: Drinking plenty of water is essential to keep stools soft and prevent straining during bowel movements.
    • Hygiene Practices: Maintaining good hygiene, especially in the anal area, can help prevent infections that might worsen a fistula. Regular cleaning with mild soap and water is recommended.

    Medications for Fistula

    Medications can be used to manage symptoms and control infections associated with fistulas:

    • Antibiotics: These are prescribed to treat or prevent infections that can occur in and around the fistula tract. They are particularly useful if there is an abscess or ongoing infection.
    • Anti-Inflammatory Drugs: These medications help reduce inflammation and pain, providing relief from discomfort associated with fistulas.
    • Pain Relievers: Over the counter pain medications, such as ibuprofen or acetaminophen, can help manage pain and improve comfort.

    Fibrin Glue Injections

    Fibrin glue injections offer a minimally invasive treatment option for fistulas:

    • How It Works: Fibrin glue is a biological adhesive composed of fibrinogen and thrombin, which are natural proteins involved in blood clotting. The glue is injected into the fistula tract to seal it and promote healing.
    • Effectiveness: This treatment is effective for some patients, particularly those with simple fistulas. However, success rates can vary, and it may not be suitable for complex fistulas.
    • Advantages: The procedure is quick, involves minimal discomfort, and does not require a lengthy recovery period. It is often performed on an outpatient basis.

    These non-surgical treatments can provide significant relief and are an integral part of a comprehensive management plan for fistulas.

    Fibrin glue injections offer a minimally invasive treatment option for fistulas:

    • How It Works: Fibrin glue is a biological adhesive composed of fibrinogen and thrombin, which are natural proteins involved in blood clotting. The glue is injected into the fistula tract to seal it and promote healing.
    • Effectiveness: This treatment is effective for some patients, particularly those with simple fistulas. However, success rates can vary, and it may not be suitable for complex fistulas.
    • Advantages: The procedure is quick, involves minimal discomfort, and does not require a lengthy recovery period. It is often performed on an outpatient basis.

    These non-surgical treatments can provide significant relief and are an integral part of a comprehensive management plan for fistulas.

    FAQs

    The complexity of fistula surgery varies; some procedures are minor, while others are more extensive. SCI Hospital can assess and recommend the appropriate level of intervention.

    Post-surgery discomfort is common but manageable with medication. SCI Hospital provides comprehensive care to minimise pain.

    The best treatment depends on the fistula's type and complexity. Consulting SCI Hospital specialists ensures personalised treatment plans.

    Most patients return to normal activities post-recovery, with guidance from SCI Hospital for a smooth transition.

    While non-surgical methods manage symptoms, surgery is often needed for a permanent cure. SCI Hospital offers both options.

    Medications can manage symptoms and infections but are not a cure. SCI Hospital integrates medication with other treatments for effective management.

    It depends on the procedure; SCI Hospital's experienced surgeons can determine the necessary intervention level.

    Recovery generally takes a few weeks, with SCI Hospital providing detailed post-operative care instructions.

    The best method varies by case; SCI Hospital's specialists offer personalised recommendations based on the patient's condition.

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    Written By: Dr. Sanjeev Kumar Gupta
    Education: MBBS, MS - General Surgery
    Experience: 27 Years

    Dr. Sanjeev Kumar Gupta is a distinguished surgeon who has dedicated over two and a half decades to advancing surgical care. His expertise encompasses a wide range of surgical procedures, with particular emphasis on minimally invasive techniques. At SCI International Hospital, he has established himself as a leading expert in laparoscopic, general, and bariatric surgery, consistently delivering exceptional patient outcomes through his precise surgical techniques and comprehensive approach to patient care.

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