The fistula is a pathological canal that connects the hollow organs or foci of the disease, the body cavity, the hollow organ with the surface of the body. Fistula of the rectum - one of the most unpleasant diseases, causing a lot of inconvenience. In order to avoid complications in the form of a pathology transition to a chronic form or the formation of a tumor at the site of the lesion, it is necessary to seek medical help and treatment in time.
The causes of fistula in the rectum
Fistula of the rectum, which is a pathological passage between the gut and skin around the anus, develops as a result of an acute purulent process. Most often this is the result of proctitis - infection of the rectal canal (rectum) wall or paraproctitis - infection of the tissue surrounding the rectum. With these pathologies, a peri-rectal abscess is formed, which is opened, forming a fistula.
These are the main causes of fistula formation. Other reasons may be:
- granulomatous regional enteritis;
- hernial inflammatory protrusion of the walls of the rectum;
- operative resection of the rectum;
- birth trauma ;
- complications of gynecological interventions;
- tuberculosis of the rectal passage;
- diverticular bowel disease;
- chlamydia ;
- oncoprocess;
- HIV, AIDS, syphilis, etc.
Fistula of the rectum - symptoms and complications
The main signs of the fistula of the rectum:
- the presence on the skin of the perianal area of the fistula is a wound, from which the syphilis and pus are periodically allocated;
- pain sensations of different intensity, amplified by palpation, sitting, walking, defecation (if the fistula is well drained, there is a slight pain);
- presence of swelling and redness in the affected area;
- increased body temperature;
- poor state of health, deterioration of sleep, nervousness.
As a rule, the disease proceeds wavy - it is possible to remission, and after a while - relapse. Complicated, long-existing fistulas of the rectum are often accompanied by local changes - cicatricial changes in the muscles, deformation of the anal canal, insufficiency of the anal sphincter. If the fistula of the rectum is not treated for many years, then the disease can become malignant.
Rectal fistula treatment
The only effective method of treating the fistula of the rectum is a surgical operation. There are several methods of surgical interventions, but at the heart of all of them lies the excision of the fistula of the rectum. The choice of technique is determined by the type of fistula, the presence or absence of scars and inflammatory changes. In some cases, in the preoperative period, antibiotic therapy is required to eliminate inflammatory infiltrates, and physiotherapy may also be prescribed.
During the period of remission, when the fistulous passage is closed, the operation is not practical because of the lack of clear guidelines and the possibility of damaging healthy tissues. The operation is performed in the "cold" period of the disease.
During the operation, the following manipulations are possible:
- Additional opening and drainage of purulent swelling.
- Cutting off the flap of the mucocutaneous tissue and moving it to close the fistula's opening.
- Sphincter closure, etc.
Fistula of the rectum - postoperative period
After surgery, patients are prescribed conservative treatment, which includes:
- Anesthetic and anti-inflammatory drugs.
- Warm bed baths with antiseptic solutions.
Wound healing occurs on average within a month. The duration of tissue regeneration depends on the volume of surgery and compliance with medical recommendations. In the postoperative period, physical activity should be excluded.