COLON RECTAL SURGERY
A fistula is a channel that connects two organs that should not be connected. Fistulas can occur between the anus and skin, the vagina and rectum, or arteries and veins. When it comes to colorectal issues, anal fistulas and obstetric fistulas are common. An anal fistula is an abnormal channel between the anus and the skin. An obstetric fistula is an abnormal channel between the vagina and the rectum. Fistulas may occur due to an abscess, injury or inflammation. It may lead to fecal incontinence, pain, and odor. Fistulas may be treated with medication, but in most cases, they are repaired with different surgical methods.
Types of Surgery
There are four different types of fistulas. The first type of fistula is called a complete fistula. It opens on the inside of the body and the outside of the body. It is called complete because the channel goes all the way through. A blind fistula is one that opens only on one side of the body but still connects two structures. An incomplete fistula is similar to a blind fistula except it does not connect all the way to another structure. A horseshoe fistula connects the anus to the skin but instead of going straight through the rectum; it goes around. If you have inflammatory bowel problems, you are at a high risk for a fistula. The inflammation, ulcers, and destruction of the good bacteria in the intestine may create a fistula in the intestine. If you are a man, you do not have to worry about rectovaginal fistulas. For women, another cause of fistulas includes childbirth. Sometimes obstructions during labor create channels between the rectum and vagina.
Fistulas do not heal on their own. It requires treatment with medication or surgery. Before surgery, you may need treatment for the cause of the fistula. If an infection is the cause of a fistula, the doctor will give you antibiotics to treat the infection. If you are having inflammatory bowel problems, you will be given medication to reduce the swelling and control the disease. The use of medications likes Remicade may cure fistulas brought on by Crohn’s disease. In other cases, you need surgery to cure the problem.
There are several surgical techniques for repairing fistulas. The first method of treatment involves sewing a plug into the anal fistula to close it up. The plug is typically tissue from your body, but it could also be biologic tissue from another organism. The tissue grows in the fistula and completely closes it up. The next method of treatment involves the sphincter muscle. The surgeon cuts the sphincter muscle, makes an open passage and turns the channel into a groove. The groove takes some time to heal. This is a common form of treatment, especially if there is damage to the sphincter muscle from the fistula. The third form of treatment is the use of a tissue graft. The doctor will take tissue from another part of the body and patch the fistula with it. If you have recurring fistulas, you may need a colostomy.
A colostomy is a procedure that requires the diversion of a piece of the large intestine to the outside of the body. This surgery gives the area associated with the fistula time to heal. Part of the intestine is put through an opening on the outside of the body called a stoma. The intestine comes through the outside of the abdomen. A bag is attached to the outside of the body to collect waste. After the fistula heals, the colon is reconnected to the rectum, the hole in the abdomen is patched up, and the bag is removed.
Fistula healing may take some time. In some cases, it can be six months. After surgery, you should be aware of abnormal bleeding, fever, or pus. If you notice these things, you may need to go to the doctor and make sure you do not have an infection. Risks of surgery include infection, bleeding, and injury. Risks are typically low for fistula repair. It is important to keep yourself clean and keep the area that is healing dry. Try to eat a diet that keeps you regular. Constipation may hinder the healing process. Cream may also be used for antibiotic purposes or itching purposes. The cream can decrease irritation and assist with healing.
Fistulas are very uncomfortable and require treatment. Treatment is dependent upon the cause. If you have bowel diseases, fistulas are common and in most cases recurrent. Fistulas typically happen due to injury and abscess in the colon. If you are a woman, childbirth is a major risk factor. It is hard to prevent fistulas but if they do occur there are many options for repair. The location and size of the fistula help the doctor determine which method of repair is best. When you are having recurring problems, you may need more surgery. Fistulas can be embarrassing but through repair, you will be able to feel normal again.
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