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Best Fistula Treatment in Bangalore
What is Anal Fistula?
An anal fistula is a tunnel connecting the skin near the anus to the inside of the bowel (usually the rectum). This means that the inside of the bowel is connected to the outside of the body through an additional opening. An anal fistula often results from a previous or current anal abscess. As many as 50% of people with an abscess get a fistula. However, a fistula can also occur without an abscess.
Fig 1. Fistula
Types of Fistual in Ano
Fistulas are classified by their relationship to parts of the anal sphincter complex (the muscles that allow us to control our stool). They are classified as
- Intersphincteric
- Transsphincteric
- Suprasphincteric
- Extrasphincteric
Most common is Intrasphincteric and least common is Extrasphincteric.
Based on the complexity of fistula, risk of incontinence and risk of recurrence, it is divided into
- Simple fistula
- Complex fistula
- Simple fistula:
- They involve less than 30% of external spinchter.
- Complex fistula:
- Involves more than 30% sphincter muscle
- Fistula associated with preexisting fecal incontinence, inflammatory bowel disease, or prior radiation.
- Simple fistula:
Causes of anal fistula
- Crohn’s disease (an inflammatory disease of the intestine)
- Radiation (treatment for cancer)
- Trauma
- Sexually transmitted diseases
- Tuberculosis
- Diverticulitis
- Colorectal Cancer
Symptoms of anal fistula
The signs and symptoms of an anal fistula include:
Frequent anal abscesses
Pain and swelling around the anus
Bloody or foul-smelling drainage (pus) from an opening around the anus. The pain may decrease after the fistula drains.
Irritation of the skin around the anus from drainage
Pain with bowel movements
Bleeding
Fever, chills, and a general feeling of fatigue
Anal fistula surgery aims to correct an anal fistula and treat all of its associated symptoms. If you have any of the above symptoms or you’re concerned about having an anal infection, abscess or fistula, speak with Dr. UDAY RAVI, the best fistula specialist in BENGALURU.
Diagnosis of anal fistula
Dr. UDAY RAVI will diagnose an anal fistula by examination of the area around the anus. He will look for an opening (the fistula tract) on the skin, then try to determine how deep the tract is, and the direction in which it is going. In many cases, there will be drainage from the external opening. Some fistulas may not be visible on the skin’s surface. Doctor might advise MRI fistulogram of the anal area to get a better view of the fistula tract. Few patients may require colonoscopy to rule out IBD which causes recurrent fistula.
Fistula in Ano Treatment in BENGALURU
When it comes to best fistula treatment in Bengaluru, surgery is often the primary approach for effective management. While there may be some post-operative pain, bleeding and wound healing challenges, these are typically manageable with proper care. However, two critical aspects to discuss with your fistula surgeon in Bengaluru are incontinence and recurrence.
Pain : Post-surgery pain is common, but advanced surgical techniques help minimize discomfort. Completely painless fistula surgery in Bengaluru may not be possible, but proper care can significantly reduce pain.
Bleeding : A small amount of post-operative bleeding, such as oozing, is normal. The extent depends on the wound and procedure type. Trusting an experienced fistula specialist in Bengaluru ensures safe and effective care.
Wound Healing : The wound size varies based on the fistula’s complexity and the chosen surgical procedure. Typically, healing takes about 2-3 weeks, especially under the care of a skilled fistula surgeon.
Incontinence : Incontinence, or the inability to control bowel movements, is a crucial concern when considering fistula surgery. For high or complex fistulas, sphincter muscle cutting may be required, increasing the risk of incontinence. Opt for a renowned fistula treatment center in Bengaluru for better outcomes.
Recurrence : Recurrence is a possibility in any fistula treatment. Simple fistulas managed with sphincter-cutting surgery often have a lower recurrence rate than complex cases treated with sphincterpreserving procedures. Discussing the recurrence risk with the best fistula surgeon Dr. Uday Ravi in Bengaluru is essential for informed decision-making.
Different Surgical Methods of Fistula Treatment:
There are two main types of fistula surgery :
Sphincter-Cutting Surgery
Sphincter-Preserving Surgery (SPS) : This approach is chosen when there’s a high risk of incontinence with sphincter-cutting surgery. While SPS reduces incontinence risk, it has a higher chance of recurrence compared to sphincter-cutting surgery. The recurrence rate varies depending on the specific procedure and surgeon’s skill.
Fistulotomy :
This involves cutting along the whole length of the fistula to open it up so it heals as a flat scar. A fistulotomy is usually done in simple fistula where the risk of incontinence is less. It is not suitable for complex fistula
Dr. Uday Ravi Fistula Specialist Surgeon in Bengaluru uses a LASER as an adjunct to Fistulectomy to minimize the risk of damage to the sphincter muscle. Thus, with the added advantage of Laser, the chances of post-operative pain will be negligible.
Ligation of the intersphincteric Fistula Tract (LIFT) :
The ligation of the intersphincteric fistula tract (LIFT) procedure is a best treatment for fistulas that pass through the anal sphincter muscles, where a fistulotomy would be too risky. This is a highly efficient procedure with almost no recurrences or incontinence. Dr. Uday Ravi is a well-known fistula surgeon in Bengaluru, specializes in complexfistula surgery.
Dr. Uday Ravi has performed hundreds of modified LASER LIFT procedures with excellent results which is an advanced procedure for fistula treatment in Bengaluru.
FiLaC ( Fistula-tract Laser Closure) :
It is a minimally invasive fistula-in-ano surgery that keeps the sphincter intact. This technique attempts to gently remove the anal fistula by using laser energy. The flexible, all-around radiating fiber-optic probe is inserted into the fistula tract from the outside. Then the laser is slowly withdrawn. The inflammatory tissue is destroyed in a controlled manner and the fistula tract contracts. The anal gland that originally caused the fistula is inactivated. Dr. Uday Ravi does the best laser fistula treatment in Bengaluru.
VAAFT :
Video-assisted anal fistula treatment (VAAFT) is a new minimally invasive and sphincter-saving endoscopic treatment for complex fistulas. The fistula tract and internal fistula are localized using a fistuloscope inserted through the external opening and under direct vision fistula tract is destroyed from the inside and closure of the internal opening is done by stapling or suturing or cutaneous-mucosal flap.
FISTULA PLUG :
The fistula plug is a 100% synthetic bio-absorbable scaffold. This plug is placed in the fistula tract. Over time cells from the body migrate into the scaffold and new tissue is generated as the body gradually absorbs the plug material, leaving no permanent material in the body.
PILTEC : A modification of the LIFT procedure
According to Dr. Uday Ravi, a successful fistula surgery requires proper diagnosis, a perfectly performed and reported MRI, along with the surgeon’s expertise and the method of surgery. Dr. Uday Ravi, thebest fistula surgeon in Bengaluru performs a single-setting surgery with a success rate of more than 90% including fistula with perianal abscess. It is not only about surgery Dr Uday Ravi and their team provide very good postoperative care which is one of the most important components in the complete cure of fistula.
Post-operative care after fistula surgery
- Take sitz baths (sit for 15-20 minutes in warm water with antiseptic solution) three times a day and after each bowel movement for the first few days.
- If you were given a topical ointment, place this over the anal skin and a little into the anal canal 2-3 times a day.
- Don’t worry if you have some bleeding, discharge, or itching during your recovery. This is normal.
- Avoid constipation.
- Take stool softener before bedtime every day till wound healing.
- The use of dry toilet tissue should be avoided. After bowel movements use a jet water cleaning, if possible, followed by taking a warm bath.
- If you were given a prescription for an ointment, apply these two or three times a day at the edge of the anal opening and inside by finger (not by applicator).
- Eat a regular diet including plenty of fresh fruit and vegetables. Drink 6-8 glasses of water a day.
Connect with Dr. Uday Ravi your fistula surgeon if your temperature is greater than 101 degrees, significant bleeding, and unbearable pain.
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ABOUT DR.
Dr. Uday Ravi is a renowned consultant General, Laser, Laparoscopic, Robotic and Bariatric surgeon practising in Bangalore since 15 years. He completed his MBBS from VIMS Bellary and MS from prestigious Bangalore Medical College, Bangalore. He has many fellowships FARIS, FMAS, FALS, FIAGES, FISCP and DMAS(France).
Dr. Uday Ravi has been practicing proctology for more than a decade. He has done 1000s of proctology cases in Bangalore. He is one of the best and leading proctologist in Bangalore.
Surgically advanced techniques, and latest treatment modalities with laser & stapler, are used to ensure that post operative follow-ups & dressings are minimal, patients are more comfortable and have less pain. He ensures patients can resume their normal lifestyle in a short period of time.
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