A fistula is a connection between an intestine, organs or blood vessels that is abnormal because it is not meant to connect. Fistulas can develop because of a variety of health conditions and can also result from surgery or an injury. Symptoms of a fistula often involve pain, tenderness, high temperatures, itching and fatigue. Sometimes there is pus or a discharge if the fistula has become infected.
Types of Fistulas
There are three primary types of fistulas: a blind fistula, which will have one open end; a complete fistula, which has an internal and external opening, and an incomplete fistula with an opening at the skin, without any attachment to an organ. The majority of fistulas fall into these three categories, but some may have multiple branches.
Some fistulas are caused by diseases that involve inflamed bowels, such as colitis or Crohn’s disease. Sometimes a physician may create a fistula during a medical procedure. Fistula can also be a complication of surgeries on the gallbladder. It is important for the underlying medical condition causing the fistula be treated to avoid complications and reduce the development of additional fistulae. If there is a severe trauma to the body, a fistula may develop in the blood vessels and constrict the flow of blood. According to the Fistula Foundation, approximately 2 million women have untreated fistulas as a result of childbirth.
The treatment options available depend on the type of fistula, its location and the path that it might take should it continue developing. After a thorough examination by a physician, treatment will be assessed depending on the age of the patient. Normally, if the fistula has an external opening, it is easy to determine the location, but the internal opening can be difficult to find. A scope may be inserted into the area to determine where the internal opening is. In some cases, a contrast solution may need to be injected and an X-ray or MRI test conducted to determine the path of the fistula.
For some types of fistulas, such as an anal fistula, an antibiotic may be prescribed to help cure the infection and heal the fistula. Normally, surgery for a fistula is only undertaken once this method has proved to be ineffective.
Surgery is usually required so the fistula can be drained. In some cases, pus develops in the area and it is important to drain it so that it does not abscess. In a fistulotomy, a tube is passed through part of the fistula, which allows for drainage. An endorectal flap may be created so that the healthy tissue is put over the fistula to prevent bodily waste from causing an infection. It is important to note that fistulas can recur and become infected despite surgical methods.
Sometimes, a plug can be inserted to help seal the fistula and prevent contaminants from entering the area. This treatment does not involve cutting the fistula open and works by injecting a glue-like substance into the opening after cleaning out the fistula. The area is sealed shut with a collagen protein and is closed.