A fistula is an abnormal tunnel connecting two body damage to the teeth (such as the rectum and vagina) or a body cavity of the skin (as in the rectum outside the body). One way a fistula may form is by an abscess - a pocket of pus in the body. Abscess can be continuously filled with body fluids such as urine or faeces, which prevents healing. Finally pipe breaks the skin, a body cavity or organ. Fistulae occur more commonly in Crohn's disease than ulcerative colitis. Approximately one quarter of people with Crohn's disease develop fistulas.
Types of fistulas
Fistulae often occur in the area around the genitals and anus (known as the perineum). Four types of fistulas are:
* Enterocutaneous: This type of casing pipe from the skin. An enterocutaneous fistula is a complication of the surgery. It can be described as a corridor progresses from the intestine in this operation and then the skin.
* Enteroenteric or Enterocolic: This is a tube in small or large intestine.
* Enterovaginal: This is a tube that goes into the vagina.
* Enterovesicular: This type of pipe going into the bladder. These fistulas can result in frequent urinary tract infections, or the transfer of gas from the urethra during urination.
Symptoms
Symptoms of fistula may include pain, fever, tenderness, itching, and feeling generally weak. Tube or pus may escape a smelly discharge. These symptoms vary depending on the severity and location of the tube.
Diagnosis
Fistula, depending on location, can be demonstrated by a number of diagnostic tests often used in IBD. Barium enema, colonoscopy, sigmoidoscopy and upper endoscopy can be used.
Another test, a fistulogram, can also be used. In this test, ink injected into the pipe, and X-rays are taken. Ink tube helps to better show on X-rays. Ink is inserted into the rectum, similar to an enema, for fistula in the rectum. Paint must be within 'to' during the procedure. With a tube outside the body, ink is placed in the hole with a small tube. X-rays are taken from different angles, so a patient may have positions in X-ray table change. As with any other type of X-ray, the rest is still important.
For a suspected bladder enterovesicular () fistula, an intravenous pyelogram (IVP), a different type of X-ray is done. Prepping for this test is a clear liquid diet or fasting, because the stool in the colon can obstruct views of the bladder. Dye (contrast material) is injected into the arm, and a number of X-rays are taken.
Complications
A tube can form an abscess when closed, or if it is infected. An abscess is an infection in a cavity in the body.
Treatment
Treatment of fistulas vary depending on the location and severity of the symptoms. Medical treatments include Flagyl (an antibiotic), 6-MP (an immunosuppressant), or Remicade.
Enteral nutrition can be used for enterovaginal fistulas, and enterocutaneous enterovesicular. A diet drink or enteral nutrition via a feeding tube. This liquid diet formula to substitute solid foods and contain important nutrients. No solid food has less relief passes through the anus, which helps heal tube and maybe even closure.
Fistulae not responding to one of the above therapy may require surgery. If the pipe is a healthy part of the intestine can be removed without any part of the intestine. If the pipe is in a very sick part of the bowel, surgery may be performed.
A removal can result in a temporary ileostomy. Fron ileostomy is avoided by, making a part of the intestine with a fistula time to heal. This type of surgery is often done on enterovesicular or rectovaginal fistula.
Prognosis
Location and the severity of the tube play an important role in determining treatment. With proper care a fistula can be treated and cured and should not reoccur. Dr. Ripudaman Singh
