What Is a Fistula?
A fistula is an abnormal connection or tunnel between two parts of the body that don’t normally connect. It often forms between organs, blood vessels, or between an organ and the skin. Fistulas can cause infections and other complications if left untreated.
What Are the Common Types of Fistulas?
Fistulas can occur in various parts of the body. Common types include:
- Anal or rectal fistula: Connects the anal canal to the skin around the anus.
- Enterocutaneous fistula: Connects the intestines to the skin.
- Vesicovaginal fistula: Connects the bladder to the vagina.
- Rectovaginal fistula: Connects the rectum to the vagina.
- Arteriovenous fistula: Connects an artery to a vein, often created surgically for dialysis.
- Obstetric fistula: Occurs due to childbirth injuries, connecting the birth canal to the bladder or rectum.
What Causes a Fistula?
Fistulas can be caused by:
- Infection or abscesses
- Surgery complications
- Inflammatory diseases like Crohn’s disease or ulcerative colitis
- Trauma or injury
- Radiation therapy
- Cancer
- Childbirth injuries (in obstetric fistulas)
What Are the Symptoms of a Fistula?
Symptoms depend on the type and location but may include:
- Pain or swelling near the area
- Drainage of pus or stool from an opening in the skin
- Frequent infections
- Leakage of urine or feces from unusual places
- Skin irritation or inflammation
- Fever or general discomfort
How Is a Fistula Diagnosed?
Diagnosis usually includes:
- Physical examination
- Imaging tests like CT scan, MRI, or ultrasound
- Endoscopy or colonoscopy for internal fistulas
- Dye tests or contrast X-rays (fistulogram)
How Is a Fistula Treated?
Treatment depends on the type, size, and severity. Options include:
- Medications: To reduce inflammation or fight infection
- Drainage: To relieve abscesses or infection
- Seton placement: A surgical thread placed to help drain and gradually close the fistula
- Fistulotomy: A surgical procedure to open and heal the fistula
- Flap surgery: Tissues are used to close the internal opening
- Biologic therapy: Used in Crohn’s-related fistulas
- Stoma creation: In severe intestinal fistulas to allow healing
Can Fistulas Heal on Their Own?
Some small or simple fistulas may close with medication and rest, but many require surgery or medical procedures for proper healing.
What Are the Risks if a Fistula Is Left Untreated?
- Chronic infection
- Abscess formation
- Skin damage
- Fecal or urinary incontinence
- Nutritional deficiencies
- Life-threatening complications in severe cases
When Should I See a Doctor?
Seek medical attention if you notice:
- Abnormal openings or drainage from your skin
- Persistent pain, swelling, or fever
- Unexplained leakage of stool or urine
- Recurring infections
How Can Fistulas Be Prevented?
While not all fistulas can be prevented, you can lower your risk by:
- Treating infections and abscesses promptly
- Managing conditions like Crohn’s disease effectively
- Practicing good hygiene
- Getting proper prenatal care during pregnancy
- Avoiding unnecessary surgeries or trauma