A fistula is an abnormal tunnel between any two parts of the body. An anal fistula is a tiny unnatural tunnel between the anal canal (muscular opening of the anus) and the anal skin. In the medical realm, it is termed fistula-in-ano.  

The anus serves as an endpoint to your digestive tract. The solid waste from your body is excreted out from the anus. When the anal glands get infected with bacteria and viruses, they get blocked. Blocked glands lead to the formation of an abscess. A fistula forms when the infection persists, and the abscess does not heal properly. The sticky pus is formed inside the abscess and tries to find its way out through the anal fistula. Gradually, pustular discharge begins to leak and start causing you pain. 

If left untreated, an anal fistula can get complex due to the recurrence of the abscess. It can lead to fecal incontinence (inability to hold stool) and anal skin infection.  An anal fistula is a surgical condition, but the surgery of an anal fistula can lead to fecal incontinence or recurrence of an anal fistula. However, some cases of anal fistula can be treated with homeopathy. Intervention with homeopathy in post-surgical cases of anal fistula helps heal the tract completely. These medications reduce your pain, swelling, pus, and blood discharge from the anal fistula.

Role of homeopathy in anal fistula

Homeopathic medicines can be an effective mode of treatment for anal fistula. If you start it early, in case of a recurrent anal abscess, it can prevent complications of forming an anal fistula. Homeopathic medicines selected based on symptoms aim to heal the abnormal tract and control pus discharge. It relieves pain, reduces itching, swelling, and lowers the inflammation around the anal region. It helps in regularizing bowel movements and prevents recurrent infection.

Top five remedies for anal fistula

Hepar sulphuris calcareum 

Common name: Hahnemann’s calcium sulfide

Hepar sulph. is recommended in cases of anal fistula with extreme pain, swelling, and pus discharge. It helps control the pus and blood discharge from the anal fistula. Hepar sulph. is indicated to relieve discomfort in anal fistula that is aggravated by sitting. This remedy is beneficial for anal fistula accompanied by burning and itching sensation in the anus. Fistula accompanied with fever and chills responds well to Hepar sulph.

Silicea terra (Sil.)

Common name: Silica, Pure flint

Silicea is one of the most recommended medicines for anal fistula with a constant or recurrent discharge of pus or blood. Sometimes the discharge can be white, brownish, copious, and highly offensive with a putrid smell. Silicea acts by controlling the process of pus formation and helps to heal the tract. It is suited for sharp, stitching pain in the rectum due to perianal swelling with inflammation. Perianal pain that worsens on walking and during or after bowel movements are other characteristics of this remedy.

Myristica sebifera (Myris.)

Common name: Brazilian ucuba

Myristica sebifera works well in cases of suppurative anal fistula that are difficult to heal. It helps manage chronic anal abscesses that recur again due to infections. This remedy acts by speeding up the process of pus drainage and supports the healing process of anal fistula. 

Myristica helps reduce pain, soreness, inflammation, and redness of the anal region. Using this remedy can help prevent the need for surgery in anal fistula.

Calcarea phosphorica (Calc-p.)

Common name: Phosphate of lime 

Calcarea phos. is a natural medicine for treating anal fistula with thick and yellow pus discharge. Sometimes the discharge is blood-stained. In cases needing it, there is severe, smarting or burning pain after passing stool, that lasts for hours. It acts by hastening pus drainage. Healing of anal fistula occurs by correcting chronic obstinate constipation.

Paeonia officinalis (Paeon.)

Common name: Peony

Paeonia is prescribed for anal fistula with burning and throbbing pain. It provides relief from shooting pain and itching near the anus. This remedy gives good results in persistent pus and blood discharge from the anal fistula. It helps reduce soreness, redness, and discomfort in the anal area.

Causes of anal fistula

Anal abscess

The most common cause of anal fistula is an untreated or inadequately treated anal abscess. When your anal gland gets blocked, infection develops and it forms into an anal gland abscess.

Inflammatory bowel disease (IBD)

Inflammatory bowel conditions like Crohn’s disease and ulcerative colitis can increase the risk of anal fistula.

Infection

Bacterial, viral, or fungal infections of the anal or rectal area can cause abscess formation and anal fistula.

Sexually transmitted infections (STIs)

STIs, like gonorrhea and chlamydia, can cause infections in the anal area and contribute to the formation of anal fistula.

Tuberculosis (TB)

Tuberculosis infection can lead to the formation of anal fistula.

Trauma or injury

Injury to your anal area during childbirth or any other trauma can result in anal fistula.

Chronic constipation

Straining during passing bowels due to chronic constipation can cause anal fissure, which may become infected and lead to abscess and anal fistula.

Genetic factors

Genetic predisposition can increase the risk of anal fistula. 

Immunocompromised disorders

Immune deficiency disease conditions that weaken the immune system, like HIV/AIDS or medications that suppress your immune response, can make you more susceptible to infections that can lead to anal fistula.

Symptoms of anal fistula

The most common presenting symptom of anal fistula is an opening (hole) near the anal skin and fluid discharge from it. 

The other symptoms of an anal fistula are as under:

  • A constantly oozing discharge from the anal fistula is the second common symptom. It can be pus or even blood-stained, or rarely fecal discharge. The fluid leaking from the anal fistula can be foul-smelling.
  • Pain and discomfort in and around the anus. It is often a sharp, shooting, throbbing, pulsating, tearing, or stitching type of pain. The pain worsens during bowel movement and while sitting.  
  • Tenderness and soreness around the opening of the anal fistula are felt due to inflammation and swelling of the perianal area. 
  • Irritation, itching, and burning near the anal area are other associated symptoms of anal fistula.
  • Few cases of anal fistula present with fever with chills.
  • A feeling of fatigue and weakness can accompany the above symptoms.

Treatment for anal fistula 

Surgery

Depending on the type of anal fistula, the surgery can be simple or complex. 

  • Simple fistula                                                                                                                                                                                                                                                                                                                                                                                       
  • If you have a simple fistula that involves a minimal amount of rectal muscle and doesn’t involve any branches, a fistulotomy is done. In fistulotomy, your colorectal surgeon will cut through the fistula and remove infected tissue. This allows the fistula to fill in from the bottom up.
  • Complex fistulas

If you have a complex fistula involving a significant amount of muscle, the risk of complications from surgery increases. The different techniques include seton drain ligation of the intersphincteric fistula tract (LIFT), and endorectal advancement flap. 

Diet and lifestyle changes for anal fistula

  • Incorporating high-fiber foods like fruits, vegetables, whole grains, and legumes into your diet, reduces the risk of constipation. This in turn decreases straining while passing stools, which helps reduce the risk of developing anal fistula.
  • Add foods rich in probiotics, like yogurt, kefir, sauerkraut, and kimchi, to your diet. Probiotics can reduce the risk of infections.
  • Drink plenty of water to stay hydrated. It helps in smoother bowel movements and lowers the strain on the anal region.
  • Dairy and processed foods can add up to constipation in some people. Reduce your consumption if you have constipation.
  • Practice good anal hygiene. Clean your anal area with mild soap and water after passing stools.  
  • Warm baths (sitz baths) can provide relief by soothing anal discomfort, reducing inflammation, and promoting healing. 
  • Do not strain during bowel movements. This can worsen your fistula. 

Conclusion

Pain, foul-smelling discharge, bleeding, and pus from anal fistula can affect your routine life. Left untreated, it can have serious complications. Try homeopathy for managing anal fistula and relief from the symptoms of pain and discomfort.

References