JAN EMMANUEL D.

SERRANO BSN IV-1

CASE STUDY

FISTULA IN ANO

An anal fistula is a tunnel that runs from inside the anus -- the hole your body uses to get rid
of solid waste -- to somewhere in the skin around it. It usually follows an infection that didn’t
heal the right way. Your doctor can repair the fistula, but you'll need surgery for that.

What Causes It?

Just inside your anus are several glands that make fluid. Sometimes, they get blocked or
clogged. When that happens, a bacteria buildup can create a swollen pocket of infected
tissue and liquid. Doctors call this an abscess.
If you don’t treat the abscess, it’ll grow. Eventually, it’ll make its way to the outside and
punch a hole in the skin somewhere near your anus so the gunk inside it can drain. The
fistula is the tunnel that connects the gland to that opening.
Most of the time, an abscess causes a fistula. It’s rare, but they can also come from
conditions like tuberculosis, sexually transmitted diseases, or an ongoing illness that affects
your bowels.

What Are the Symptoms?

The most common ones are:

 Pain
 Redness
 Swelling around your anus

You might also notice:

 Bleeding
 Painful bowel movements or urination
 Fever
 A foul-smelling liquid oozing from a hole near your anus

How Is It Diagnosed?
If the doctor thinks you have an anal fistula, she’ll ask about your medical history and give
you a physical exam.
Some fistulas are easy to spot. Others aren’t. Sometimes they close on their own, then
open back up. Your doctor will look for signs of oozing fluid or bleeding. She might stick a
finger into your anus during the exam.
She’ll probably send you to a specialist in colon and rectal problems for more exams or
imaging tests like X-rays or a CT scan. You might even need a colonoscopy. For this test,
the doctor will put a tube with a camera on the end into your anus to look at the inside of
your bowels. You’ll be asleep when this happens.

Treatment
There’s no medication to fix the condition, so surgery is used. The procedure can usually
take place in a doctor’s office or clinic. You won’t have to go to the hospital.

 For a simple fistula that isn’t too close to your anus, the doctor will cut open the skin
and muscle surrounding the tunnel. This allows the opening to heal from the inside
out.
 She may use a plug to close the fistula.
 For a more complicated fistula, the doctor might put a tube -- known as a seton --
into the opening. This helps drain the infected fluid before surgery. It could take 6
weeks or more.

Depending on where the fistula is, your doctor may have to cut into the sphincter muscles
that open and close your anus. She’ll try not to damage them, but it may be harder to
control your bowels after the procedure.