Anal fistula is commonly caused by abscesses of anal glands which are located between the two layers of the anal sphincters and drain into the anal canal.
Anal fistulas per se do not generally harm, but can be very painful, and can be irritating because of secretions (i.e. pus or stool).
Treatment: In abscesses, the treatment consists of surgical opening and abscess drainage. Fistulas are surgically removed. Since the fistula can also run through larger portions of the continence apparatus, sometimes a radical removal is problematic. Alternate treatment options include the anal fistula plug.
A fistula plug involves plugging the fistula with a device made from small intestinal submucosa. The fistula plug is positioned from the inside of the anus with suture. Small intestinal submucosa stimulates the body to close the fistula from the inside out. According to some sources, the success rate with this method is as high as 80%. As opposed to the staged operations, which may require multiple hospitalizations, the fistula plug procedure requires hospitalization for only about 24 hours. This treatment option does not carry any risk of bowel incontinence.
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