home Drugs Rectal fistula: symptoms, treatment with folk remedies at home. Treatment of rectal fistula without surgery: reviews. Popular and effective treatment of fistulas

Rectal fistula: symptoms, treatment with folk remedies at home. Treatment of rectal fistula without surgery: reviews. Popular and effective treatment of fistulas

A rectal fistula is a canal that occurs directly in the layer subcutaneous tissue and then passes through adjacent tissues. Such formations can be internal and external. The first connect the patient’s organs to each other. The latter go outside. You can look at photos of these types to understand the difference. This is not hemorrhoids, which in its first symptoms are similar to the problem of a fistula. Treatment of the disease is also carried out in a completely different way.

More than 90% of all people suffering from rectal fistula deal with an advanced stage of paraproctitis, when conservative treatment already useless. This is entirely the patient’s fault, since the visit to the doctor should not have been delayed. The result is that the abscess opens and all its contents come out. Of course, the patient immediately feels relief, but this does not mean that the disease has passed. Inflammation remains, an infection can get there, which will provoke further development into a fistula extending onto. Bye inflammatory process goes on, fistulas continue to form, and treatment is definitely necessary.

Surgeons' mistakes during operations:

If the abscess is opened, drained, but nothing radical is done, a rectal fistula may appear.
If hemorrhoids require surgical intervention, surgery is performed, but the doctor may affect the muscles by suturing the mucous membrane. The result is inflammation. Fistulas form in postoperative period. Moreover, this can be not only complicated hemorrhoids, but also an advanced version of it.
If deep, traumatic operations in gynecology were performed, but with errors. This can also cause a problem.

There are other reasons as well:

injuries after childbirth;
syphilis;
chlamydia;
cancerous tumors that are located in the rectum;
intestinal problems;
tuberculosis rectum;
Crohn's disease.

Any reasons that caused the problem must be eliminated.

Rectal fistula has its own special symptoms. Without them, the disease never occurs. The most frequent symptoms that worry the patient:

itching in the anal passage;
purulent discharge;
painful sensations.

Possible symptoms are fever, irritation in the anus, hemorrhoids. This disease occurs in “waves”. Therefore, symptoms may constantly recur. Recurrences of the fistula after apparent recovery occur very often. Therefore, as soon as further symptoms appear, you need to immediately consult a doctor.

Types of fistulas in proctology - clinical forms

IN medical practice There are several variants of rectal fistula:

Full ones are characterized by the presence of a stroke with two holes at once. One is in the sinus anus. The second one is coming out. There can be many such holes, which are then combined into one external passage. In the photo this is especially visible when diagnosing the disease.
An incomplete passage is a passage that has an internal opening and exits onto the intestinal mucosa. This is only the stage when the formation of a full-type fistula occurs.
Internal. These are fistulas, both openings of which are located in the wall. They vary in location relative to the anus. Most often identified through diagnostic “photos”.

Are anal fistulas dangerous?

If the fistula is not treated, it can lead to multiple complications:

Scarring of anal tissue. The result is pain during bowel movements. The same symptoms characterize hemorrhoids.
Blood poisoning.
It is possible to achieve the degeneration of a fistula into a cancerous tumor.
Scarring of tissues that are located around the problem area. The result of such a complication is intestinal problems, fecal and gas incontinence.

All this significantly complicates the quality of life of patients.

Folk remedies to help

Many people who suffer from hemorrhoids, as well as rectal fistula and other intestinal problems, use traditional medicine to relieve symptoms or try to get rid of ailments altogether.

Facilities traditional medicine should be used only after diagnosis and on the recommendation of a doctor.

Today there are a lot of such folk recipes:

You can treat the problem with calendula flowers. To do this, dry and fresh flowers pour alcohol and infuse. The resulting product is mixed with boric acid and boiled water. The finished solution is used as candles. A tampon is soaked in it and inserted into the rectum. This treatment must be carried out for at least 10 days.
Aloe is used with success (hemorrhoids are also treated with this home remedy). Finely crushed leaves are poured with honey and left for 8 days. Afterwards, it is recommended to use the product orally 3 times a day.
It is often used to relieve symptoms. For this, infusions of chamomile, calendula, and oak bark are prepared.

How to get rid of it?

Rectal fistula should not be treated exclusively folk recipes. They may help, but this can only achieve temporary results. The main problem will not disappear, but the patient will only waste time. Treatment must be carried out under the supervision of a doctor.

The main effective way to treat rectal fistula is surgical intervention(operation).

Excision is performed in acute period. When remission occurs, experts do not consider it advisable to perform surgery, since not all pathological tissues can be removed.

Surgical treatment may vary in its technique. This depends on many parameters:

what type of fistula is presented;
Do you have hemorrhoids?
are there any ulcers present?
whether scarring has begun;
What is the current period of the disease?

The surgeon must perform it very competently surgical treatment fistulas. Photos of the operation are available on the Internet. You can watch them.

The operation takes place in a hospital. Used general anesthesia. After which the patient should be under the close supervision of a doctor for a week. The treatment doesn't end there.

After the operation, active healing of the damaged area occurs. This period lasts several weeks. In this case, the patient may feel pain in the wound area. Therefore, the doctor prescribes painkillers.

You need to quickly go to the surgeon if after surgery the patient develops:

haemorrhoids;
temperature increase;
severe pain;
fecal incontinence;
difficulty urinating or defecating.

In this case, treatment will be continued. Perhaps in the form of another operation.

In the postoperative period, you will have to follow a diet to preserve the intestines and make the patient feel better.

After surgery you need to eat only for 2-3 days liquid food. This will prevent constipation, hemorrhoids and other complications will not develop. Treatment in the postoperative period also includes taking sitz baths. They are prescribed without fail. You can use infusions of various soothing herbs.

Rectal fistula is one of the symptoms of the disease that no one will discuss with family. Many people are embarrassed to seek help from specialists with such problems. But paraproctitis is an insidious disease that causes not only moral suffering, but also physical pain. The disease rarely goes away without consequences. However, it can be defeated with the help of many medicines. With rectal fistula it is noted sharp pain in the area and perineum. The disease is often accompanied by defecation disorders, chills and fever. Often with paraproctitis there is difficulty urinating. Typically, specialists suggest surgical intervention to relieve the patient of the disease. However, some practice treating rectal fistula without surgery.

Why does the disease occur?

Why does paraproctitis occur? There are many reasons why of this disease. Most often, the disease is provoked by factors that can reduce immunity. Among them it is worth highlighting:

Poor nutrition.
Sedentary, sedentary lifestyle life.
Acute or chronic form of infection of the digestive tract.
Stool disorders: constipation, diarrhea.
Chronic diseases.

Statistics show that the disease mainly affects women. The reason for this lies in wearing thongs, bikinis, and tight-fitting pants. Clothes made of thick fabric are especially dangerous. It can rub the skin in the perineal area. In addition, hypothermia can cause inflammation. After all, many women wear short skirts and thin tights. In older people, paraproctitis usually occurs in chronic form. Those at risk are those who suffered an acute form of the disease in their youth.

initial stage

Treatment of rectal fistula without surgery is possible. On early stages For this disease, the doctor usually prescribes them. They must be applied to the perineal area. In addition, experts recommend carrying out procedures such as warm baths and relieving enemas. Such measures can significantly improve the patient’s condition.

Antibiotics are usually prescribed for the treatment of rectal fistula. During treatment, patients are recommended to rest in bed.

Acute form

Treatment of rectal fistula without surgery acute form also allowed. However, such therapy has some peculiarities. As a rule, doctors recommend surgery, which involves opening the abscess. But, as practice shows, many patients do this at home using alternative medicine. In any case, cleaning of the internal hole is required afterwards. If this is not done, then a relapse of this disease may occur, leading to the formation of another fistula.

Features of the disease

Even in a simple case, after eliminating the rectal fistula, a hole is formed in the anal canal. As a rule, it does not heal. In this case, a flowing fistula is formed. It is extremely rare for a scar to appear.

If any factor again provokes the development of paraproctitis, then an abscess may again form in the same canal. If there is a scar in this place, then an abscess may occur next to it. If the disease recurs, then its treatment should be the same as for the acute form.

Paraproctitis can occur even in infants. Treatment of rectal fistula with traditional methods in this case is unacceptable. The child should definitely be shown to doctors. It should be taken into account that surgical intervention is very difficult, since in young children the suppuration hole has a small diameter. This makes cleaning the canal much more difficult.

What is the best way to treat?

Is it possible to overcome rectal fistula? Treatment without surgery, reviews show, can be quite successful. Over many centuries, many methods have accumulated that allow not only to rid the patient of the disease, but also to prevent its re-development. However maximum effect can be achieved if, when treating rectal fistula, you combine traditional and unofficial medicine.

Salt baths against rectal fistula

Treatment of rectal fistula folk remedies allows you to cope with the disease much faster. As many reviews show, sitz baths with added salt can alleviate the patient’s condition and eliminate some symptoms. Such procedures cope well with inflammation and also help the pus to drain away.

This bath is very easy to prepare. First, you need to pour 5 liters into the container. boiled water. Baking soda, sea soda and regular salt. It is enough to take a spoonful of each component. The finished solution should be filtered. This bath should be taken for 10 minutes. Treatment of rectal fistula with folk remedies should be carried out in courses. You need to do salt baths for 15 days, one procedure per day. After the baths, special ointments should be used. They are usually prescribed by a doctor.

Herbal baths

How else can you eliminate a rectal fistula? Symptoms, treatment, as well as recovery from illness - all this causes many negative emotions And discomfort. To ease the course of the disease, you can take sitz baths, but not with a saline solution, but herbal decoction. You can prepare it at home.

As a rule, to treat rectal fistula, a decoction of St. John's wort, oak bark, calendula, bergenia, yarrow, calamus, and other herbs is used. To prepare the product, you need from 50 to 60 grams of herbs. This amount of raw material must be poured with boiling water (1.5 liters) and placed on fire. The herbs need to be brought to a boil and simmer for 20 minutes. Now the product should infuse. This takes about 40 minutes. Ready decoction should be strained thoroughly and then poured into a container suitable size and dilute warm water(5 liters). These baths should be taken for 10-15 minutes.

Bath recipes

Rectal fistula, which is recommended to be treated at home only under the supervision of a doctor, is a very unpleasant phenomenon. The following sitz baths can be used for therapy:

70 grams of ash must be poured with water (7 liters) and placed on fire. The product should be boiled for half an hour. After this remedy, the decoction must be filtered and cooled to a temperature of 35 to 37 °C. Take a bath for about 25 minutes. Quantity similar procedures not limited and depends on the degree of the disease.
Two liters of milk must be brought to a boil. Next, add a few onions to the container. average size and 4 cloves of garlic. You need to boil this product for 2 minutes and then cool slightly. Baths should be taken hot. In this case, the body should be wrapped in a blanket. You cannot stop the procedure until the milk has completely cooled down. The course lasts until complete recovery.

Microclysters

Treatment of rectal fistula without surgery using folk remedies is a difficult process that requires endurance and patience. The use of microenemas can increase the patient's chances of recovery. To carry out such procedures, a special bulb with a rubber tip is required. The tool must be properly cleaned before use. To avoid damaging the tissue, the tip should be lubricated with cream or vegetable oil. Here are some effective recipes:

A spoonful of honey should be dissolved in 100 grams of water. After this you need to prepare an infusion of herbs. For this you will need chamomile, yarrow and sage. The mixture must be poured with 200 grams of boiling water. In a separate container you need to mix both products, taking 1 dessert spoon of each. This solution should sit for at least 30 minutes. Before going to bed, you can douche. After this, the procedure should be repeated, but using only an infusion of herbs of about 40 milliliters. In addition, it is recommended to drink 1/3 of this medicine.
Raw potatoes must be thoroughly washed and grated along with the peel. The resulting mass should be carefully squeezed out. The resulting juice should be used for douching. A tablespoon of the product should be injected into the anus at night. The course is 10 days.
For rectal fistula, a microenema with a solution prepared from fresh calendula flowers helps. First you need to prepare the product. You need to pour 20 grams of calendula flowers into a glass of boiling water. The product should sit well. This takes several hours. The finished infusion should be filtered and can be used for its intended purpose.

Fat against rectal fistula

Badger, and will also help eliminate rectal fistula. Treatment without surgery is a long process. During therapy you can use various means alternative medicine. In addition to microenemas and sitz baths, you can use tampons. They should be soaked in fat and inserted into the anus at night.

If you do not have these ingredients, you can use fresh potato sticks. They are used like fat tampons. It is worth noting that potatoes are good at soothing irritation, and also heal and cover erosions and cracks located in the anal area.

Tea Recipes

Treatment of rectal fistula without surgery can be carried out not only using means for local application. To overcome the disease, you can drink various teas. Such remedies help cope with paraproctitis.

To prepare the drug you will need 100 grams of plantain leaves and marshmallow roots, as well as 75 grams of yarrow. All components need to be crushed and then mixed. In the evening, pour three tablespoons with 700 milliliters of boiling water. The product should sit overnight. In the morning, the finished infusion must be strained. It is recommended to drink 150 milliliters of this drug per day before meals. For greater effect You need to take the product at least 4 times during the day. It is worth noting that the infusion allows you to cope with paraproctitis and, of course, with fistula.

Rectal fistula: treatment with St. John's wort and other herbs

This is another effective way to treat rectal fistula, as well as the disease that caused it. To prepare, take a glass of 50 milliliters

herbs such as St. John's wort, basil, Japanese sofa and celandine. You will also need birch leaves. You need several of these glasses.

All crushed ingredients must be mixed and then brewed with 1.2 liters of boiling water. The container with the product should be placed on the fire and brought to a boil. You need to cook the drug for a minute over low heat. Now the broth should stand for about an hour. Ready product should be filtered and taken between main meals, at least three times a day. Dosage - tablespoon.

Experts also recommend using an infusion of these herbs for microenemas. They can be done up to 4 times during the day. After such procedures, a tampon moistened with a decoction should be applied to the places of suppuration. This remedy will help quickly eliminate rectal fistula. Treatment without surgery using the methods described above allows you to recover faster from the disease.

Rectal fistula (medical name - fistula) is a through tubular canal that connects the abdominal organs. The inside of the fistula is lined with epithelial cells or “young” connective fibers, formed as a result of the tightening and healing of various wounds and local tissue defects. About 70% of rectal fistulas are formed in the pararectal space and come from the Morganian crypts (pockets open towards movement feces) to the skin. Anorectal fistulas go from the anus directly to the skin.

Treatment of rectal fistulas usually involves the use of surgical methods, as well as mechanical and chemical cleaning of the cavity. Very often, patients who have been diagnosed with purulent fistulas of the rectum are interested in whether the fistula can be cured without surgery. Experts agree that treating pathology with medications and folk methods is ineffective and can only be used as an auxiliary component to accelerate regenerative processes and quick recovery damaged tissues. There are also methods that allow excision of a fistula without surgical (invasive) intervention, so the patient must know complete information about everyone available methods therapy.

Most proctological surgeons believe surgery the most effective method of treating various fistulas, since during the operation the doctor can remove all damaged tissue, which significantly reduces the risk of relapse. Excision of fistulas using a scalpel is an invasive, highly traumatic operation that requires long-term recovery period, so many patients are looking for ways to treat fistulas without surgery. About them and we'll talk below.

Laser treatment without surgery

This is one of the safest, most effective and least traumatic methods of treating fistula tracts, which has several advantages. Laser treatment, if indicated, can be carried out even in children and adolescents, although some doctors do not recommend using this technique in children under 10 years of age. Impact laser beams does not cause discomfort and painful sensations, and after the procedure there is no need for a rehabilitation period. After excision of the fistula with a laser, there are no scars or scars left on the skin, which is important if the operation is performed in the anorectal area.

Despite the large number of advantages, laser treatment also has significant disadvantages, including:

high cost (in different clinics the cost can vary from 20,000 to 45,000 rubles);
a fairly high probability of relapses and complications (about 11.2%);
side effects in the form of anal itching and burning at the site of excision of the fistula;
impossibility of use for purulent fistulas.

Note! Laser excision of fistula tracts is practiced in all private clinics in large cities, so there are usually no problems finding a laser proctologist surgeon.

Radio wave therapy

More in a modern way Removal of rectal fistulas is radio wave therapy. The method is suitable for the treatment of all types of fistulas, and its main advantage is the absence of the need to go to the hospital. The patient can go home within 10-20 minutes after the procedure, since it does not require general anesthesia: the doctor performs all actions under local anesthesia(traditionally Lidocaine or Ultracaine is used).

Complete healing and tissue restoration after radio wave excision of the fistula occurs within 48 hours, so if the fistula was removed on Friday, the patient can go to work on Monday (the standard recovery period after surgery– at least 14 days). To determine the most suitable treatment method for himself, the patient can use the comparative characteristics given in the table below.

Table. Comparative characteristics various methods of treating rectal fistulas.

Options	Laser treatment	Radio wave therapy	Surgical excision using a scalpel
Need for hospitalization	Usually not required (in some cases, the doctor may recommend observation for 1-2 days).	Not required. The patient can leave the clinic 20 minutes after the procedure.	The patient must be hospitalized in a hospital 2-3 days before the scheduled operation. After excision, the patient remains in the hospital for about 2-3 weeks.
Use of general anesthesia	Not required.	Not required.	Depending on the shape of the fistula and the extent of tissue damage, general anesthesia may be required.
Scars and scars after surgery	The probability is less than 5%.	The probability is less than 1%.	The probability is more than 92%.
Postoperative pain	None.	None.	They may bother you for several months, especially if the patient has a tendency to have stool disorders.
Healing and recovery period	From 2 to 5 days.	48 hours.	Three weeks.
Probability of relapses and complications	About 11.2%.	Practically absent.	Complications may occur.
Price	20-45 thousand rubles.	14,000 rubles.	It is carried out free of charge under the compulsory medical insurance policy.

Important! Despite all the advantages non-invasive methods treatment of perirectal fistulas (without a scalpel), the final decision on the possibility of using these techniques should be made by the doctor, based on the degree and severity of the lesion and the general condition of the patient.

Treatment of rectal fistulas with traditional methods

When choosing the most appropriate treatment method, patients should understand that effective way The only treatment for anorectal and pararectal fistulas is surgical therapy. Traditional methods can be used as an auxiliary agent that relieves inflammation, draws out pus and ensures the outflow of exudate. Some components effectively eliminate pain and accelerate tissue healing, but complete recovery after using even the most effective recipes impossible. It's connected with anatomical features structure of the fistula tracts, therefore the recipes below are recommended to be used only as an auxiliary therapy after consultation with a doctor.

Honey ointment

Natural honey is one of the most effective anti-inflammatory remedies in traditional medicine. Honey and bee products (propolis, beebread, royal jelly) contain more than 20 components that soothe the skin, relieve inflammation and stimulate tissue regeneration.

To prepare it, you need:

Mix 5 tablespoons of liquid honey with two tablespoons of melted honey butter(use only natural oil, made from pasteurized cow's cream);
add 15 drops of fir oil to the mixture;
heat in a water bath until boiling and remove from heat;
put in the refrigerator for 8 hours.

The resulting ointment must be lubricated with the affected area (you can use a tampon) 5-6 times a day. Treatment should be continued for 3-4 weeks.

Herbal ointment with lard

Recipes based on lard used for fistulas accompanied by the formation purulent exudate. Mixture medicinal herbs disinfects the skin, prevents ascending infection of the rectum and soothes inflamed tissue, accelerating healing and tissue restoration. To prepare the ointment you need:

in a deep bowl, mix 1 teaspoon each of oak bark, chamomile and water pepper herb;
add 300 ml of water and put on low heat for 20 minutes;
Cool the broth and strain, then add 4 tablespoons of melted lard to it;
mix everything and put it in the refrigerator to harden.

If the finished ointment is very liquid, you can add 1-2 tablespoons of butter, previously crushed using a fine grater, and then put the product back in the refrigerator. The ointment must be applied to a cotton swab and applied to the inflamed area. The tampon should be changed every 3-4 hours. Have a good one therapeutic effect can be achieved after 2-3 weeks of daily use.

Lotions with aloe juice and plantain

Juice squeezed from aloe leaves has a pronounced bactericidal and anti-inflammatory effect. Such lotions draw pus from the wound, ensure its disinfection and reduce the intensity pain syndrome. Plantain has a stimulating and regenerating effect, so herbalists advise adding this component to traditional treatment aloe.

To extract juice from aloe leaves, they must be thoroughly washed. cold water, crush in your hands and cut along the side line, then squeeze out the pulp from them. Plantain can be used as an infusion: pour 10 g of dried plantain root with a glass of boiling water and leave for 2 hours. All ingredients must be mixed and refrigerated for 1 hour.

A mixture of aloe juice and plantain infusion is used in the form of lotions: a cotton swab must be moistened generously with the product and applied to the end of the fistula tract. Lotions must be changed every 4 hours. Duration of use – 2 weeks.

Lotions with calendula

This is the easiest way to treat fistulas at home. All you need is an alcohol tincture of calendula (you can buy it at a pharmacy for 30-50 rubles) and cotton pads or swabs. The tampon must be moistened generously with the tincture and applied to the fistula for 20-30 minutes. You need to make 5-6 lotions per day. The duration of treatment depends on the tolerability of the components and the existing dynamics. The recommended course of therapy is 7-10 days.

Note! Make lotions with alcohol tinctures necessary after hygienic washing. At the beginning of treatment, the patient may feel a strong burning sensation caused by the effect of ethanol on the inflamed tissue. If such sensations do not go away within 30 minutes after removing the tampon, the skin should be rinsed generously with running water. cool water and lubricate with a soothing ointment, for example, Bepanthen.

Olive oil and vodka ointment

This ointment helps to quickly relieve inflammation and has a positive effect on the condition of damaged tissues, stimulating their regeneration. So that there is ointment thick consistency, you must purchase in advance any fat base (glycerin, badger or goose fat etc.). Mix 5 tablespoons of oil (it is better to use premium oil) with 50 ml of vodka and add 3 teaspoons of glycerin. If animal fat is used for cooking, the required thickness can be achieved using two tablespoons of fat.

All components should be thoroughly mixed and refrigerated for several hours. The ointment should be used up to 4-5 times a day; there is no need to wash it off after use. Significant improvements are usually observed already on the seventh day of treatment, but to achieve a stable result it is recommended to use the product for at least two weeks.

Rectal fistula is an unpleasant painful pathology, which can lead to serious complications if it is not treated on time. The only one effective method The only treatment for rectal fistulas today is excision, which can be performed without surgery or the use of a scalpel. Home methods can be used as complementary therapy, but they cannot replace full-fledged treatment.

Video - Excision of rectal fistula

Fistulas or fistulas of the rectum (fistulae ani et recti) are a serious pathology associated with the formation of purulent passages through the connective tissue of the rectum. The exit of the fistula tunnels may end in the peri-rectal tissue. These are incomplete internal fistulas. More often, the passages are completely open and open through the skin in the anus area, so-called complete external fistulas.

What is a rectal fistula?

Rectal fistula is a chronic inflammatory process anal gland, usually located in the area of the Morganian crypts (anal sinuses), as a result of which a passage is formed in the wall of the rectum through which inflammatory products (pus, mucus and ichor) are periodically released.

Fistula is a chronic paraproctitis, in which there is a constant discharge of pus from the fistula opening. The inside of the tract is covered with epithelium, which prevents it from closing and healing on its own.

Disease code according to ICD-10:

K60.4 – Rectal fistula. Cutaneous (full).
K60.5 – Anorectal fistula (between anus and rectum).

The mere presence of a lesion chronic infection adversely affects the body as a whole, weakening the immune system. Against the background of fistulas, proctosigmoiditis can develop. In women, infection of the genital organs with the development of colpitis is possible.

Causes

The occurrence of fistulas is associated with an infection that penetrates the intestinal lining and surrounding tissues. First, the fatty tissue around the intestine becomes inflamed (). At the same time, pus begins to accumulate.

Ulcers break out over time, leaving tubules called fistulas. They may scar or continue to become inflamed and fester.

In proctology, about 95% of rectal fistulas are the result of acute paraproctitis. The infection, penetrating deep into the wall of the rectum and surrounding tissue, causes the formation of a perirectal abscess, which opens, forming a fistula. The formation may be associated with the patient’s untimely contact with a proctologist, non-radicality surgical intervention with paraproctitis.

The nature of the disease, in addition to the considered connection with acute paraproctitis, can also be post-operative or post-traumatic. For example, in women, fistulas at the junction of the vagina and rectum are predominantly formed as a result of birth injuries, which can happen in particular due to ruptures of the birth canal, with protracted labor or breech presentation of the fetus.

Rough forms of gynecological manipulation can also provoke the formation of fistulas.

The reasons for the formation of a fistula are as follows:

failure to consult a doctor in a timely manner if paraproctitis develops;
incorrectly prescribed treatment;
improper performance of an operation to remove an abscess, accompanied only by opening and draining the abscess without prescribing correctly selected antibiotic therapy.

The appearance of fistulous openings in the anal area may be associated with the following diseases:

diverticulitis (inflammation inner shell large intestine)
tuberculosis of the rectum

Kinds

All types of fistulas have the same structure - entrance, channel and exit. The entry hole may form in different places, For example:

near the anus;
on the buttock;
in the perineum;
in or close to the vagina (rectovestibular fistula);
in the layers of subcutaneous tissue.

Depending on how the fistula tract is located in relation to the anal sphincter, intrasphincteric, extrasphincteric and transsphincteric rectal fistulas are determined.

Intrasphincteric fistulas are the simplest; they are diagnosed in 25-30% of cases of the formation of such formations. Their other designations are also used in this embodiment, namely, marginal or subcutaneous-submucosal fistulas. They are characterized by the directness of the fistula tract, the unexpressed manifestation of the scar process and the insignificant duration of the disease.
Transsphincteral. The fistulous tracts of such formations contain purulent pockets, branches in the perirectal tissue and scar changes caused by purulent fusion of tissue. The channels of such fistulas pass through the superficial, subcutaneous or deep portion of the sphincter.
Extrasphincteric rectal fistula is the most complex look, affecting most of the sphincter, and at the same time having swelling various forms. The treatment is quite complex with various plastic forms, and is even carried out in several stages.

Symptoms of rectal fistula in adults

Manifestations of rectal fistula depend on the location of the fistula with purulent contents and the condition immune system, which will determine the severity of the manifestations of such a pathological formation.

After suffering paraproctitis in a patient:

there is pain in the anus;
a hole appears from which pus is released (traces of it will be visible on underwear and/or clothes).

Sometimes, along with purulent discharge, ichor remains on the tissue, appearing due to damage blood vessels. If the fistula does not have an external outlet, then the patient experiences only pain and/or discharge from the lumen of the rectum or vagina.

The presence of incomplete internal fistulas causes a feeling of presence in patients foreign body in the anus area. If there is insufficient release of infiltrate from the fistula cavity, patients feel:

pain and discomfort in the anal area
retention of stool and urination
discharge from the rectum (pus, infiltrate, mucus)
irritation and redness skin around the anus and part of the buttocks
fever, chills.

In the chronic form of the disease, especially during the period of exacerbation, the following set of symptoms is noted:

There may also be pathological changes physically:

the posterior opening is deformed;
scarring appears muscle tissue sphincter;
dysfunction of the sphincter.

During remission general state the patient is not changed, and with careful hygiene, the quality of life does not suffer greatly. However, a long course of rectal fistula and constant exacerbations of the disease can lead to:

Depending on the stage and form of the disease, symptoms alternate.

Diagnostics

At the initial stage, a patient survey is conducted, during which complaints characteristic of this pathology are identified. Diagnosing a fistula usually does not cause difficulties, since already upon examination the doctor detects one or several openings in the anal area, upon pressure on which purulent contents are released. At digital examination a specialist can detect the internal opening of the fistula.

In addition to examination and history taking, the patient is prescribed tests:

blood chemistry,
general blood and urine analysis,
stool occult blood test.

Instrumental methods for diagnosing rectal fistulas:

Sigmoidoscopy is an endoscopic examination of the rectum using a tube inserted into the anus. This method allows you to visualize the rectal mucosa, as well as perform a biopsy in order to differentiate a rectal fistula from a tumor, in case of suspicion.
In order to clarify the position of the rectal fistula and the presence of additional branches, ultrasonography is performed - ultrasonography pararectal tissue.
Fistulography is an X-ray contrast study where a special device is inserted into the hole. contrast agent, then pictures are taken. From them one can judge the direction of the fistula tract and the location purulent cavity. This study must be carried out before surgery.

Treatment

It is important to understand that fistulas cannot be cured. medications and traditional medicine. The only treatment that can achieve a complete cure for the disease is surgery.

Drug therapy is used solely to relieve symptoms and as aid, accelerating recovery.

fourth generation systemic antibiotics for oral administration: Metronidazole, Amoxicillin;
painkillers: Detralex, Hemoroidin, Phlebodia;
healing drugs with anti-inflammatory properties (externally): Levosin, Levomekol, Fuzimet.
full course of physiotherapeutic procedures: electrophoresis, ultraviolet irradiation.

Operation

Treatment for fistula is surgical. The main goal is to block the entry of bacteria into the cavity, clean it and excise (remove) the fistula tract.

The operation to remove a rectal fistula is usually prescribed routinely. When chronic paraproctitis worsens, the abscess is usually opened urgently, and the fistula is removed after 1-2 weeks.

Contraindications for surgery:

Severe general condition.
Infectious diseases in the acute period.
Decompensation of chronic diseases.
Blood clotting disorder.
Kidney and liver failure.

Depending on the complexity of the fistula, the following surgical methods can be performed:

excision along the entire length of the fistula with or without suturing the wound;
excision with plastic surgery of the internal fistula opening;
ligature method;
laser cauterization of the fistula;
filling the fistula tract with biomaterials.

A well-executed operation specialized hospital 90% guaranteed complete cure. But, as with any operation, there may be undesirable consequences:

Bleeding both during and after surgery.
Damage to the urethra.
Suppuration of a postoperative wound.
Incompetence of the anal sphincter (incontinence of feces and gases).
Recurrence of the fistula (in 10-15% of cases).

Staying in the hospital after surgery:

The first days when the patient is in the hospital, a gas tube is placed, analgesics and antibiotics are prescribed, and dressings are performed.
From the 2nd day, food is allowed - gentle and easily digestible food in pureed form, drinking plenty of fluids. Sitz baths with a warm antiseptic solution, pain-relieving ointments, and, if necessary, laxatives and antibiotics are prescribed.
The length of hospital stay after the intervention can vary - from 3 to 10 days, depending on the volume of the operation

After discharge from the hospital, the patient needs to be especially attentive to his own well-being and immediately consult a doctor if the following symptoms occur:

Sudden rise in temperature
Constant pain in the abdominal area
Fecal incontinence, excess gas
Painful bowel movements or urination
The appearance of purulent or bloody discharge from the anus.

It is very important that the patient did not have stool for the first 2-3 days after the operation. This will provide the wound with sterile conditions for healing. Subsequently, the diet expands, but it is necessary to avoid constipation, which can cause sutures to separate. Additional recommendations:

Meals should be fractional, 6 times a day in small portions.
It is important to drink enough fluids, at least 2 liters of water per day, so that the body recovers faster and also to prevent constipation.
You should not eat foods that irritate the intestines. These include carbonated and alcoholic drinks, chocolate in large quantities, hot spices and flavorings, chips, fatty meats, etc.

Forecast:

Intrasphincteric and low transsphincteric fistulas of the rectum can usually be permanently cured and do not entail serious complications.
Deep transsphincteric and extrasphincteric fistulas often recur.
Long-term fistulas, complicated by scarring of the rectal wall and purulent leaks, may be accompanied by secondary functional changes.

Prevention

Effective prevention of the inflammatory process of the rectum are the following recommendations specialist:

balanced and fortified diet;
final abandonment of all bad habits;
timely treatment of chronic diseases of the gastrointestinal tract;
refusal of emotional shocks and stress.

Rectal fistula is dangerous disease, which can cause discomfort with its unpleasant symptoms and cause complications. When the first signs appear, be sure to seek help from a proctologist.

It often happens that an infection that progresses inside seeks a way out. This especially happens after surgery. Let's look at why this happens and how the resulting fistula is treated after surgery.

Fistula - what is it?

A fistula is a canal that connects body cavities or hollow organs to each other or to external environment. It is lined with epithelium, and through it pus comes out, or the canal is lined granulation tissue. If this does not happen, then a purulent fistula forms.

Such a process may be the result of some inflammatory process in the body or a consequence of surgery.

Types of fistulas

Depending on where the fistula is located, they are divided into:

Gastric fistula.
Rectal.
Rectovaginal fistula.
Duodenal.
Bronchial.

The fistula can be complete or incomplete. A complete one has two holes and is treated faster, since it has a way out; an incomplete one, having one hole, further develops the inflammatory process, the number of bacteria increases.

The fistula can be labiform or tubular. Labial can only be treated with surgery.

If we consider the process of formation, then a granulating fistula is one that is not yet fully formed, while a tubular one is already lined with epithelium and is fully formed.

What are the reasons for the appearance of a fistula after surgery?

There are several reasons for this phenomenon:

The last point is the most common reason why a fistula appears after surgery. There are also several explanations for this:

Non-sterile suture material.
The body's reaction to a foreign body.

The fistula on the suture after surgery forms a seal from the suture thread itself, fibrous tissue and collagen fibers.

How to recognize the appearance of a fistula after surgery?

Since this is primarily an inflammatory process, it is necessary to recognize a fistula after surgery characteristic symptoms not difficult. They are:

If you experience such symptoms, you need to see a doctor immediately, otherwise the infectious process may spread to your organs or cause blood poisoning.

Diagnosis of fistula

Diagnosing a fistula after surgery is not difficult, since it can be seen visually if it is external. The doctor, after listening to the patient and examining him, pays attention first of all to:

Quantity and quality of discharge.
The size of the fistula, its color.
If the fistula is interorgan, then pay attention to the work of neighboring organs, especially if there are changes.

In order to find out the length and direction of the fistula canal, probing and radiography are used.

It is also necessary to do a series of tests that will confirm the type of fistula. The gastric will show the presence of hydrochloric acid, and uric - the presence of uric acid salts.

It happens that the suture may begin to fester a long time after the operation, so you need to find out the reason for this phenomenon.

If a fistula does appear after surgery, how to treat it?

Treatment of fistulas

For successful therapy First of all it is necessary:

As a rule, the wound begins to heal. If this does not happen, then surgical intervention is possible, in which excess granulation is removed, and the areas can be cauterized.

The newest method is the treatment of fistula after surgery using ultrasound. This method is considered the most gentle, but it is not fast.

IN severe cases if several fistulas have formed, excision is indicated postoperative scar fully. The infected suture material is removed and a new suture is placed.

Postoperative intervention

If you still failed to cure the fistula and had to resort to operational methods, then after surgery to remove the fistula, healing will take place within several weeks. The wound will heal faster if you provide it with complete rest and proper care.

After surgery for a rectal fistula, the doctor, as a rule, prescribes a diet so that the wound heals faster. After such operations, painkillers and antibiotics are required. The wound heals within a month; any physical activity is avoided.

The prognosis for treatment is usually good and the patient makes a full recovery.

Traditional methods of treatment

Of course, people always try to cure the disease at home. There are several recipes for treating fistulas with folk remedies. Here are some of them.

It is worth noting that if a fistula has formed after surgery, then treatment should be carried out under the supervision of doctors, and folk remedies are an addition to the main course.

Prevention of fistulas

In order to prevent fistulas from appearing after surgery, it is necessary:

First of all, observe the rules of asepsis during surgery.
All instruments and suture material must be sterile.
It is necessary to treat the wound before suturing it.
Vessel doping should occur with little tissue involvement.
Prescribe antibacterial drugs to prevent infections.
Everything needs to be treated infectious diseases, preventing the development of fistulas.