Understanding Fistula in Ano

Definition

• A fistula in ano is a small tunnel or passage that forms between the inside of the rectum or anus and the skin around the bottom.

Causes

• Often caused by infections.
• Blockage in a small gland inside the anus can lead to bacterial growth.
• This infection may develop into a pocket of pus called an abscess.
• Untreated abscess can create a fistula to drain the pus.

Symptoms

• Pain or discomfort near the bottom.
• Swelling or redness in the area.
• Pus or fluid discharge from the skin near the anus.

Types of Perianal Fistulas

1. Inter-sphincteric fistula:
   • Simplest and most common type.
   • Runs between the internal and external anal sphincters.
2. Trans-sphincteric fistula:
   • Crosses the external sphincter and can be complex.
3. Suprasphincteric fistula:
   • Less common.
   • Forms a path above the sphincter muscles.
4. Extrasphincteric fistula:
   • Rarest form.
   • Passes from the rectum to the skin, bypassing the anal sphincter completely.

Treatment Options

• Fistulectomy or Fistulotomy
  • Involves complete removal or opening of the fistula to promote healing from inside out.
• FiLaC (Fistula Laser Closure)
  • Minimally invasive option using laser energy to close the fistula tract.
• Seton placement
  • Surgical thread placed within the fistula to allow drainage and reduce recurrence risk.

Note

• Hemorrhoids share similar symptoms with fistulas.
• Further information on hemorrhoids and their treatment is available in a follow-up video.