An unusual connection between formed two organs or tissues as a result of surgery, injury, disease or due to abnormalities in growing fetus is known as fistula. These abnormal links may develop in any part of the body. An arteriovenous fistula is created surgically to aid in hemodialysis in patients suffering with poor functioning kidneys. Arteriovenous fistulas generally develop after injury. Fistulas can be of different types. Blind fistula opens at one end, complete fistula has both opening interior and external, horseshoe fistula that connects anus to the skin after going through the rectum and incomplete fistula that develops from the skin with a closed internal opening and does not connect to any other structure.
These abnormal links between different organs are dangerous and life threatening. Hence, treatment for fistula should be initiated immediately after diagnoses.
Fistula treatment
Depending on the organs involved in the formation of abnormal connection and severity of the condition a fistula treatment strategy is planned.
Ayurvedic treatment for fistula
Three different treatment strategies are used in Ayurveda to treat fistula.
Kshar Sutra: In this technique the fibrous tissue is removed by inserting a medicated thread called setone in to the fistula by making an incision. Various herbal medicines that aid in draining, cutting and healing of the fistula are used to coat the setone. Best part of this treatment is it can be done on out-patient basis and the patient can continue with the normal routine. This is a time taking treatment
Enema: In this method the lower body part of the patient is given hot baths. During the treatment the patient is checked for signs of diabetes and hypertension.
Agnikarma: In this method a hot iron agent is used in eliminating the damaged tissue.
Fistula surgery
Treatment for fistula involves performing a surgery to cut open the passage and drain the contents. Depending on the type of fistula, different types of surgery are used.
- Fistulotomy in which both the openings of the fistula are opened to clear the contents of fistula is used for superficial fistulas.
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Advancement flap procedure: Treatment for complex fistulas is generally performed through this surgical procedure. In this procedure an advancement flap is replaced at the opening of the fistula after removing the fistula. - Bioprosthetic plug: In this procedure a bioprosthetic plug is used to close the interior opening of the fistula. Fistula heals with the draining of contents from the exterior opening.
Advancement flap procedure: Treatment for complex fistulas is generally performed through this surgical procedure. In this procedure an advancement flap is replaced at the opening of the fistula after removing the fistula.Possible Complications of surgery
- Recurrence of fistula is the common complication of fistula surgery. The newly formed fistula should again be closed by performing a surgery.
- Incontinence of stools in case of anal fistula surgery due to damage to anal sphincter.
- Infection can develop if proper care is not taken to maintain hygiene at the site of surgery. Oral antibiotics should be taken to prevent infections.
Use of natural antibiotics
Surgery is not a suitable treatment for fistula formed in the perianal region due to high risk of recurrence. Application of natural antibiotics such as oregano oil in to the interior of fistula helps in healing of the fistula. Oregano oil kills the pus causing bacteria and promotes healing of wounds.
Warm compress and Sitz bath
Application of warm compresses also helps to heal the fistula. Warmth aids in removal of dead and infected tissue from the fistula.
Sitz baths are mainly helpful in treating anal fistula. This treatment for fistula aids in promoting blood circulation to the area and in flushing the fistula contents. This in turn prevents oozing of the fistula, irritation of the area promoting faster healing.
Sealing the fistula using fibrin glue, glue made from fibrin protein present in blood is another treatment to cure fistula. Though this procedure is associated with high risk of recurrence it does not cause the problem of incontinence when used to treat anal fistula.
Precautions in fistula treatment
In addition to using right treatment for fistula it is very important to follow certain precautions to promote faster healing of the fistula.
- Maintain good hygiene to prevent infections.
- Drink plenty of fluids especially fresh fruit juices and water.
- Oral antibiotics or antibiotic ointments should be used as prescribed by the physician to prevent infection.
Arteriovenous fistula created surgically by connecting an artery and vein to aid in dialysis should given good care to prevent infections. Antibiotics prescribed by the physician should be taken regularly. The wound should be cleaned regularly without causing any damage to the opening of the fistula. To promote normal blood flow through the fistula, it is essential to wear lose fitting clothes and avoid lifting weights. Any pressure on the fistula can increase risk for formation of blood clots. Physician should be consulted immediately if there are signs of pimples, swelling, bleeding or redness at the site of surgery.