User:Mr. Ibrahem/Anal fistula

Anal fistula
Other names	Anal fistulae, fistula-in-ano, anorectal fistula
Different types of anal fistula
Specialty	General surgery
Symptoms	Pain, drainage of pus.
Usual onset	20s to 40s
Duration	Long standing
Types	Simple, complex
Causes	Anal abscess
Risk factors	Obesity, diabetes, smoking, high blood lipids, lack of exercise
Diagnostic method	Examination under anesthesia, medical imaging
Differential diagnosis	Anal carcinoma, anal fissure, hemorrhoids, perianal abscess, diverticulitis, hidradenitis suppurativa, pilonidal cyst
Treatment	Surgery
Frequency	12 per 100,000 (males) 6 per 100,000 (females)

An anal fistula is a abnormal communication between the anal canal and usually the skin around the anus that is long standing in nature. Symptoms may include rectal pain and drainage of pus. Complications may include fecal incontinence, anal stenosis, and recurrence of the fistula.

The most common cause is a prior anal abscess which does not heal properly. Risk factors include Crohn disease, radiation therapy, obesity, diabetes, smoking, high blood lipids, and a lack of exercise. They generally start from an anal gland, which are located between the internal and external anal sphincter and drain into the anal canal. If there is a single tract, less than 30% involvement of the external sphincter, and no underlying cause it is classified as simple, otherwise it is classified as complex. Diagnosis may require examination under anesthesia or medical imaging.

Treatment is generally via surgery using one of a number of techniques. Antibiotics are typically not needed. Though, those related to Crohn disease may be, at least initially, treated with medications. About 12 in 100,000 males and 6 per 100,000 females are affected. Onset is usually between the ages of 20 and 40.