Facts about Fistula disease

A fistula is an abnormal tube-like connection occurs between two organs or vessels that are lined with epithelial cells. Fistulas are normally caused by injury or surgery, but they can also result from an infection or inflammation. Fistulas are disease condition, but they may be surgically created for therapeutic reasons.

There are three common types of Fistula; Arteriovenous fistula, Anal fistula and Obstetric fistula. Most of these fistulas are in forms of a tube, some can also have multiple branches, also they are formed between the end of the bowel and skin near the anus (anal fistula) or between the intestine and the vagina (Obstetric fistula). These two fistulas (Anal & Obstetric fistula) are termed Natural fistula.

Sometimes artificial fistula may be created, for example, between an artery and vein (arteriovenous fistula) when a person needs renal dialysis. An arteriovenous fistula may also be caused by injury.

The following are more descriptions about the most common types of fistula together with their causes and treatment.

A. ARTERIOVENOUS FISTULA

Is an abnormal connection between an artery and a vein. These connection are congenital; can occur at any point in the vascular system; and vary in size, length, location, and number. Usually, blood flows from your arteries to your capillaries to your veins. Nutrients and oxygen in your blood travel from your capillaries to tissues in your body.

This kind of fistula cause blood flows directly from an artery into a vein, bypassing some capillaries. When this happens, tissues below the bypassed capillaries receive a diminished blood supply.

An arteriovenous fistula may develop as a complication of a process known as cardiac catheterization. Cardiac catheterization is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes.

Skin piercing injury, such as a gunshot or stab wound my develop arteriovenous fistula. This will happen if the piercing part of your body has side by side blood capillaries (Vein and Artery)

Sometimes Arteriovenous fistula my happen as an inborn disesase, probably due to the facts that the arteries and veins don't develop properly in the womb.

TREATMENT

1. Surgery

The type of your surgery will depends on the size and location of your arteriovenous fistula. Surgery can be an effective method for correcting complex congenital arteriovenous malformations, especially in the lower limbs.

2. Catheter embolization

A catheter is a thin tube made from medical grade materials serving a broad range of functions. They are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure

Embolization is an invasive treatment (minimal) that blocks one or more blood vessels or vascular channels of abnormalities.

Catheter embolization is a process of applying medications or synthetic materials called embolic agents through a catheter into a blood vessel to block blood flow to an area of the body.

3. Ultrasound-guided compression

In this treatment, an ultrasound probe is used to compress the fistula and block blood flow to the damaged blood vessels. This procedure only takes about 10 minutes. But it only works for about one in three people.

SYMPTOMS

1. Decreased blood pressure

2. Fatigue

3. Heart failure

4. Swelling in the arms or legs

5. Purplish, bulging veins that you can see through your skin, similar to varicose veins.

NB:

The above symptoms are just few, there might be more other symptoms.

B. ANAL FISTULA

Is the development of small channel between the end of the bowel and the skin near the anus, fistula can occur after surgery to drain an anal abscess. It can cause bleeding and discharge when passing stools - and can be painful.

Anal fistulas can cause discomfort and skin irritation, and won't usually get better on their own. Is the result of an infection near the anus causing a collection of pus (abscess) in the nearby tissue. When the pus drains away, it can leave a small channel behind.

During the final stage of fistula you might see the visible hole in the skin near your anus, although this may be difficult for you to see yourself.

The most causes of anal fistulas is by anal abscess, This happen if the abscess doesn't heal properly after the pus has drained away. It's estimated that between one in every two to four people with an anal abscess will develop a fistula.

SYMPTOMS

1. Smelly discharge from near your anus

2. Passing pus or blood when you defecate.

3. Swelling and redness around your anus and a high temperature.

4. Skin irritation around the anus

5. A constant, throbbing pain that may be worse when you sit down, move around, have a bowel movement or cough.

NB:

The above symptoms are just few, there might be more other symptoms.

TREATMENT

Kind of treatment will depend on the position of your fistula and whether it's a single channel or branches off in different directions. Surgery is only the best treatment for anal fistula as very few heal by themselves.

C. OBSTETRIC FISTULA

Is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labor, leaving a woman incontinent of urine or feces or both. Is the most worse and serious of all childbirth injuries.

The Obstructed labor can last up to six or seven days, which produces contractions that push the baby's head against the mother's pelvic bone. The soft tissues between the baby’s head and the pelvic bone are compressed and do not receive adequate blood flow. The lack of blood flow causes this delicate tissue to die, and where it dies holes are created between the laboring mother’s bladder and vagina and/or between the rectum and vagina.

Obstetric fistula is more common when adequate medical care is not available, is considered a disease of poverty. An obstetric fistula is almost entirely preventable. According to health advocates, its persistence is a sign that health systems are failing to meet women’s essential needs.

SYMPTOMS

1. Flatulence, urinary or fecal incontinence, which may be continual

2. Repeated vaginal or urinary tract

3. Foul-smelling vaginal

4. Irritation or pain in the vagina or surrounding areas.

NB:

The above symptoms are just few, there might be more other symptoms.

TREATMENT

Surgery is the best treatment of Obstetric fistula, though before that you must see your doctor for examination, if there is the need to heal the wounds first or not. Also this kind of fistula can be prevented by ensuring availability of medical care during women labor.

Treatment for fistula varies depending on the cause and extent of the fistula, but often involves surgical intervention combined with antibiotic therapy. It is important to see your doctor first for examination before treating a fistula so as to determine the extent and "path" that the fistula takes through the tissue.

Posted by: Lusubilo A. Mwaijengo