Fistulas can have different causes - they often occur when an abscess has formed in the body or a purulent inflammation has developed in a body cavity. Among other things, they can occur in the mouth after inflammation of the teeth as well as on the coccyx and in the anal area. Here they are often caused by chronic bowel disease such as Crohn's disease. We reveal which symptoms indicate a fistula and which treatment options exist.
What is a fistula?
By a fistula is meant a tubular connection between a hollow organ and another organ or the body surface. Depending on whether the fistula lies completely inside the body or has a connection to the outside, a distinction is made between inner and outer fistulas.
A fistula does not always consist of only one gait - in some cases, a whole network of fistula tracts can develop. Such a structure is called "Fuchsbau". Often, foxing occurs in anal fistulas caused by Crohn's disease.
Fistula and abscess
Fistulas are usually not naturally occurring compounds. They can be caused by acute or chronic inflammation, but can also be caused by external factors such as an accident or birth. In case of a fistula on the coccyx, the symptoms can also be triggered by ingrown hair.
In acute inflammation, pus in the body may form in a closed body cavity or an abscess may develop. This is understood to mean a cavity filled with pus inside the body. As pressure increases due to continued production of pus, the body creates a way to remove the pus from the tissue: a fistula is created.
If the inflammation persists, more and more new pus will be produced. As a result, the Eitergang has no way to heal.
Fistula in the mouth and coccyx
Fistulas can form in the body in various places. They are especially common in the mouth on the gum, coccyx and anus. Especially in the anal area fistulas are uncomfortable for those affected because they often do not dare to go to the doctor with their complaints.
But by itself the symptoms do not disappear: If the inflammation is not treated, the fistula may even spread even further.
What are typical symptoms of a fistula?
Depending on the location and type of fistula, various symptoms can occur:
- Many fistulas are noticeable by a swelling that may or may not hurt.
- In addition to the swelling, it can also lead to redness and overheating of the tissue.
- As other symptoms, fatigue and fever may occur.
If the fistula has a connection to the outside, it can be seen on the body surface as a small point. That is why she is often confused with a pimple. Characteristic of a fistula is that, unlike a pimple, it produces pus again and again.
Signs of anal fistula
In anal fistula, afterjucken, pain after bowel movements as well as fecal incontinence belong to the possible symptoms. If the fistula contact with the body surface, it also causes wetness in the anus region. As a result, pus and Kotspuren are often found on the underwear. Partly also creates an unpleasant odor in the genital area.
In a fistula, surgery is inevitable - by itself, this usually does not heal again. Because the body encapsulates the infection to protect itself from the bacteria. Although these bacteria can not spread throughout the body, they can not be effectively controlled by the use of drugs such as antibiotics.
Therefore, treatment with medication can not cure the fistula. Only in patients with Crohn's disease patients with fistula formation on medicines with the antibody infliximab is used.
Various surgical procedures
To treat a fistula, various surgical procedures are available. In a fistulotomy, the fistula is split, exposed and cleaned. Once the source of infection has been eliminated, the fistula can then heal itself. However, it is important for a split that the fistula does not penetrate the sphincter or any other important structure in the body.
In anal fistulas, which run through the sphincter, the fistula is not split, but cut out. Almost the entire egg course is cut out of its surroundings. Only the part that runs through the sphincter is simply scratched out. Then the muscle is stitched together again.
With an anal fistula, which is connected with the anus, also a thread drainage can be put. A thin thread is inserted through the outer fistula opening into the anus. The two thread ends are then knotted together from the outside.
Through the thread, the fistula always remains open and it can prevent a congestion and abscess formation. Many patients initially find the thread unfamiliar but no longer feel the foreign body after a few days. However, the exit area must be cleaned several times a day.
Frequently, a thread drainage over several weeks or months in the body left. In some cases, drains can heal - in rare cases even the entire fistula - through the drainage. In general, however, the thread drainage is to be regarded as preparation for a subsequent operation. In patients who are unable to undergo surgery, suture drainage may also be a long-term therapy.