Anal fistula is the common name of anorectal fistula. It is also called "anal leakage" in traditional Chinese medicine. It consists of three parts: primary internal orifice, fistula, and secondary external orifice. It is one of the common anorectal diseases. Its incidence is second only to hemorrhoids. It is 5%~10%, and the high-risk population is mostly children and male young adults.
"Because these two groups of people have relatively high levels of male hormones, the glands secrete more vigorously, and they are prone to gland infections. Abscesses appear in the early stage. If the treatment is not timely or unreasonable, it will become anal fistula." Wang Yanmei said.
"Hemorrhoids are caused by the tortuous expansion of local blood vessels around the anus, and anal fistula is an infectious disease, and it is very harmful." Wang Yanmei told reporters that abscess is the root cause of anal fistula. "Anal fistula is first caused by abscess, often due to perianal. The abscess ruptured spontaneously, the remaining poison was not exhausted, the blood flow was not smooth, and the wound did not heal for a long time, and then formed an anal fistula."
In fact, whether it is an abscess or an anal fistula in the later stage, in Wang Yanmei's view, the persistent pain brought to the patient is incomparable to hemorrhoids, and this kind of pain cannot be relieved, and later infections and repeated swelling and pain will occur.
"If a large-scale infected abscess is not properly treated, it will cause systemic symptoms of poisoning. The toxin of the abscess is absorbed by the blood, forming sepsis, and even causing toxic shock and death." Wang Yanmei once encountered Once an abscess patient developed systemic symptoms of poisoning, then multiple organ failure, and unfortunately died of septic shock. In addition, if the anal fistula does not heal for a long time, it can also cause symptoms such as anorectal stenosis, difficulty defecation, anemia, body weight loss, listlessness, and neurasthenia. Prolonged pus stimulation can also lead to perianal dermatitis, or eczema, which can cause anal itching and cause extreme inconvenience to the patient's life.
Wang Yanmei told reporters that according to the position of the fistula, anal fistula can be divided into low anal fistula and high anal fistula. Because the high anal fistula passes through the levator ani muscle (a group of muscles that close the pelvic floor), the damage to the anorectum is very serious. Patients with low anal fistulas must not delay the condition, lest the low position becomes high and the simple becomes complicated.
For patients with anal fistula who have a disease course of more than 10 years, we must be vigilant, “because this type of anal fistula may become cancerous.” Wang Yanmei had encountered 2 cancerous patients during clinical surgery. “The cause of cancerous anal fistula is not yet clear. The fundamental way to prevent cancer is timely treatment."
Surgery is the only way
"An anal fistula is different from infections in other parts of the body. Once it forms, it cannot heal itself. It is mainly because the infection entrance (inner mouth) is located in the anal canal, where there is a higher pressure (anal pressure), which prevents infection. The stove drains from here." Wang Yanmei said.
In addition, the fistula passes through the anal sphincter, and the relaxation and contraction of the sphincter will affect the discharge of pus. "However, once an anal fistula or abscess occurs, no matter the severity, medical treatment can only relieve the symptoms. If it is to be completely cured, surgery is the only way. So far, no non-surgical method has been found to cure perianal abscess and anal fistula." Wang Yanmei said.
However, Wang Yanmei also said that the damage to the anal muscles caused by traditional surgery is inevitable, but the severity of the damage is different. The best effect of the surgery is to eliminate the symptoms and prevent the anus from closing and defecation. Many losses.
It is worth mentioning that in recent years, in the treatment of high anal fistulas, Wang Yanmei led the team to make great progress. For the first time, she put forward the concept of "isobaric drainage" and achieved good results in 3 years of clinical practice.
"Compared with the traditional operation of cutting the fistula in the past, the "isobaric drainage" method does not need to open the fistula, so it will not cause damage to the muscles wrapped around the fistula, and the fistula can heal naturally." Wang Yanmei said.
During the interview, Wang Yanmei specially emphasized that once an abscess is found, radical surgery should be performed as soon as possible. The earlier the operation, the less severe the damage, and the scars did not form during the abscess period. In addition, surgery as soon as possible also avoids repeated infections during the formation of anal fistula, which may lead to aggravation of scars or evolve into complex anal fistulas, which increases the difficulty of surgery. The fewer the number of operations, the lighter the trauma.
However, for children with anal fistula, if it is subcutaneous, the operation should be performed as soon as possible. If more sphincter muscles are involved, it is best to wait until the age of 10 to perform the operation.
Why do many patients with anal fistula have repeated attacks after surgery?
"Anal fistulas vary widely, and the diagnosis is very complicated. Repeated recurrences are directly related to the initial diagnosis because the diagnosis of the lesion and the source of infection is not clear." Wang Yanmei believes that the accurate diagnosis in the early stage will affect the postoperative effect, followed by surgery. Specific operational issues.
Therefore, after the patient was diagnosed with anal fistula, Wang Yanmei suggested that she should go to a regular specialized hospital for surgical treatment, and there should be no chance to take shortcuts.
The reporter learned that anal fistula itself is an infectious disease, which is an intestinal bacterial infection. When the body's resistance is reduced, it is very easy to suffer from a variety of diseases. At this time, it is likely to cause intestinal flora imbalance, and E. coli will multiply. Infection and suppuration occurred when the inner mouth entered the perianal area.
"In fact, the anorectal area is the first alarm that reflects the physical condition of a person. Once it becomes infected, it also indicates that your body has been overdrawn during this period of time." Wang Yanmei said.
So, how should people avoid anorectal diseases such as anal fistula?
Faced with a question from a reporter from China Science Daily, Wang Yanmei suggested that if there is discomfort in the anal area, it should be paid attention to and consult a professional doctor as soon as possible. Active treatment of other anorectal diseases, such as anal sinusitis, anal papillitis, proctitis, etc., is of great significance for preventing the formation of perianal abscess and anal fistula.
"Develop a good life pattern, pay attention to work and rest, don't be overly tired, a reasonable diet of meat and vegetables, and regular anal cleansing can effectively prevent the occurrence of such diseases." Wang Yanmei said.
In addition, good bowel habits, prevention of constipation and diarrhea, more exercise, avoiding sedentary wetland, etc., can help prevent anal fistula disease.
"China Science News" (2014-07-23 6th Edition Medical Road) Reporter Qingdan Zhang