What is Fistula ?

Treatment for a fistula depends on the type, location, cause, and severity. A fistula is an abnormal connection between two body parts, such as between an organ and the skin or between two organs. Here are common types and treatment approaches:

Anal Fistula (most common type)

Treatment Options:

• Fistulotomy : Most common; cutting open the fistula to allow it to heal from the inside out.
• Seton placement : Surgical thread is placed in the fistula to keep it open and allow drainage.
• Advancement flap surgery : Used for complex or high fistulas.
• Fibrin glue or plugs : Less invasive, but lower success rates.
• LIFT procedure (Ligation of Intersphincteric Fistula Tract) : Preserves sphincter muscles.

Rectovaginal Fistula

Treatment:

• Medical management : If Crohn’s-related, anti-inflammatory or biologic drugs may help.
• Surgical repair : May involve tissue flaps or direct closure of the tract.

Enterocutaneous Fistula (Bowel to Skin)

• Nutritional support : Often with total parenteral nutrition (TPN)
• Control infection : Antibiotics and drainage
• Surgery : Once the patient is stable and inflammation subsides

General Considerations

• Antibiotics : If there is infection.
• Imaging : MRI, CT, or ultrasound may be needed to map the fistula.
• Lifestyle and diet modifications : Especially in gastrointestinal-related fistulas.