A Fistula is a permanent abnormal passageway between two organs in the body or between an organ and the exterior of the body. Fistulas can arise in any part of the body, but they are most common in the digestive tract. They can also develop between blood vessels and in the urinary, reproductive, and lymphatic systems. Fistulas can occur at any age or congenital.
Types of fistulas
- Congenital Fistula: Pulmonary arteriovenous fistula is a congenital fistula. This is an abnormal connection between the arteries and veins of the lungs. With normal circulation, the blood without oxygen goes to the lungs, and oxygenated blood then is pumped to the rest of the body by the heart. The pulmonary arteriovenous fistula allows oxygenated and deoxygenated blood to mix together, leading to some oxygenated blood being circulated to the lungs and poorly oxygenated blood being pumped to the body. The severity of the fistula determines how much oxygen is reaching the body and how much the patient is affected.
- Acquired Fistula: An example of acquires fistula is Crohn’s disease, which causes inflammation of the bowel, and can slowly destroy the delicate tissues of the intestine, can lead to an anorectal fistula. This type of fistula allows stool to travel outside of the intestine, which leads to stool coming out of the body from a place other than the rectum, such as the vagina.An obstetric fistula is a complication of a difficult childbirth, where blood supply is minimal or cut off completely to an area of abdominal tissue, often the bladder, uterus or intestine. When this tissue dies, it leaves a hole through which urine or stool can move, and the woman may experience stool leaking from her vagina or urine leaking from her anus. This type of fistula can lead to chronic infections and requires surgery.
- Surgically Created Fistulas: Surgically created fistulas should not be confused with a fistula that is an unexpected surgical complication. A surgically created fistula is intentionally created to benefit the patient. For example, a dialysis fistula, also known as a cimino fistula. Is created surgically to provide access for hemodialysis in patients with end stage renal disease. This type of fistula is typically placed in the lower arm and connects a vein and artery for improved venous access with low pressure blood flow. Intentional fistulas are also used for the treatment of portal hypertension in the liver.
Anal fistula or Fistula-in-ano
Anal fistula is an infected tunnel that develops between the skin and the muscular opening at the end of the digestive tract (anus). Most anal fistulas are the result of an infection in an anal gland that spreads to the skin
Causative factors for anal fistula:
An anal fistula is most commonly caused by an anal abscess. It can also be caused by conditions that affect the intestines. The cause of the abscess is often unknown, although abscesses are more common in people with immune deficiencies, such as HIV and AIDS. If an anal abscess bursts it can sometimes develop an anal fistula. A fistula may also occur if an abscess has not completely healed, or if the infected fluid has not been entirely drained away. Approximately 40% of people with an anal abscess will develop an anal fistula.
Other causes are
- Ulcerative colitis
- Crohn’s disease
- Cancer of rectum
- Sexually transmitted diseases
- Constant throbbing pain in anal region, throbbing and worse when sitting down
- Skin irritation around the anus, including swelling, redness and tenderness
- Discharge of pus or blood
- Constipation or pain associated with bowel movements
How to diagnose anal fistula
Usually, a clinical evaluation including a digital rectal examination is sufficient to diagnose an anal fistula, but some patients may require additional tests to screen for sexually transmitted diseases, inflammatory bowel diseases, diverticulitis and rectal cancer. Knowing the complete path of an anal fistula is important for the diagnosis and effective treatment. The opening of the channel at the skin generally appears as a red, inflamed area that may ooze pus and blood. This external opening is usually easily detected.
How Homoeopathy helps to cure anal fistula?
Homeopathy works primarily on controlling the infection which helps prevent the formation and development of abscess. Then work on the development of new fabrics to close down the stretch. When tissues are restored, the opening is closed and fistula gets cured permanently. Homeopathy can abort the tendency to abscess formation and suppuration by increasing resistance. So it can thus avoid the hindrances to cure by helping the healing process to continue naturally without interference. Also, to heal the fistula, first of all, the flow of fluid must get stopped since the draining fluid itself acts as a layer of separation to resist healing. For that, the tendency to fluid collection and suppuration must be stopped. Homeopathy provides this without any surgical measure. If the flow gets stopped, the pathway dries up naturally and shrinks to get close approximation for better healing. Medicines should be taken under the advice and diagnosis of a qualified Homeopath.
This case regards to Mr. Ahmad , 27yrs, software engineer ,he was suffered from severe pain with pus like discharge from perianal region and backache especially right side since 2yrs.Itching and burning anal region, . The patient is able to pass stools only in standing posture and the stools are very hard. His past history was typhoid at the age of 10yrs,recurrent attacks of convulsions in childhood, now he is normal, not taking any medicines for convulsions. He had one brother, both are very affectionate, suddenly he met an accident and died. After the death of his brother he felt very dull, fear that something is going to happen, hopeless feeling and deep sorrow. He consult to the allopathic physician, he was diagnosed as a case of right sided anal fistula and prescribed some medicines. At the time of medication he is normal. Again symptoms appear after stopped that medicines. Family history was father suffered from hemorrhoids and hypertension. His physical symptoms are, appetite and digestion was normal.Invoulentary urination while coughing and sneezing. He likes cold weather. Aversion to sweets, warm foods and milk. His mental symptoms are anger trifles but cannot express easily, suppressed anger when parents reprimanded, aversion to contradiction. Sympathetic nature and very sensitive, hopelessness, discouragement, weakness of memory. In this case CAUSTICUM is the indicated remedy. After 2doses of causticum-200 pain and pus like discharge slightly decreased. He continued homoeopathic medicines for 6months, anal fistula completely cured and bowels also regular.
Commonly indicated Homoeopathic remedies:
Hydrastis: It is a great remedy for anal fistula associated with prolapsed anus.Chronic constipation with unable to pass stool. Anal fissures with sinking feeling stomach and dull headache. Smarting pain while defaecation.Haemorrhoids.Gleety discharge from urethra. Dull, heavy, dragging pain in back. Stiffness in back.
Acid. Nitric: Anal fistula associated with fissure. There is marked burning pain in the anus which lasts for a few hours after passing stools, extreme exhausted after passing stools. Nitric acid is specifically suited to people who experience anal fistulas with great difficulty in passing stools.Haemorrhoids bleeds easily.Haemorrhage from bowels,profuse,bright red.Constipation with fissures in rectum stitching pain in rectum.Scanty,dark offensive like urine, smells like horse urine.
Other indicated remedies: Apis mel, Calc Flour, Calc Sulf, Capsicum, Carboveg, Collinsonia, Graphites etc.