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Fistula: Why Surgery is the Best Option?

The anal fistula is characterized by the blocking of one or many glands in the anus, caused by an infected abscess. More than 50% of abscesses in the anus may turn into a fistula (a small tunnel connected the infected anal gland to the skin around opening of anus). Thousands of people are affected by this painful and irritating medical condition. The worst hit among the genders are females and to compound on the problems, recent studies show that 1 out of every 50 women enduring the pangs of Fistula end up getting proper treatment.

Even in the 21st century, fistula is seen as something that should not be disclosed to anyone.  So, a large majority of patients decide to hush up and go without any treatment. Well, the time has come to overcome this taboo and take the fistula treatment decisions in your own hand.

Who are prone to Fistula?

Fistula, which is a resultant of abnormal connections between two interior body parts, can develop between different parts such as esophagus and windpipe, bowel and vagina, etc. They can even develop between two blood vessels (artery and veins). While some patients are born with inherited fistula, others can develop this condition as a result of complications from a past surgery, infection, injury, Crohn’s Disease or Ulcerative Colitis.

Symptoms

As mentioned before, most people in India tend to give a blind eye to this painful medical condition. But steadfastness can relieve you from all the pain. It is important that you understand the signs of Fistula and visit a doctor at the earliest.

  • Intermittent bleeding around the anus
  • Pain and swelling around the anus
  • Abscesses around the anus
  • Painful bowel movements
  • Foul smelling Pus discharges from the anal opening with some blood coming out.
  • Skin irritability experienced around the skin near anus due to persistent drainage.
  • Feeling of fatigue along with chills and fever

Diagnosing the Problem

As mentioned before, when you see or feel any of the above mentioned symptoms you should waste no time in consulting a doctor. The non-complex fistulas can be easily diagnosed by the doctor by examining the affected area around the anus. In the physical examination the doctor would be looking for external opening on the skin surrounding the anus. Examination of the opening will give the doctor a fair idea about the depth and direction of blockage. But there are other types of fistula which may not be visible on the skin’s surface. In order to diagnose such types, the doctors would prescribe certain tests.

  • Fistulogram/Sinogram: In Fistulogram real time x-rays of the anus area are done using a barium based material to produce clear images and detect abnormal passage with the patient’s body. Sinogram on the other end assess the extent of this abnormal passage.
  • Anoscopy: A small plastic or stainless steel device is inserted into the anus of the patient in this test. This device helps the doctor get a detailed look at the tissues in the anal and rectal areas.
  • CT Enterography: With the help of special x-ray equipment and injections of contrast material, detailed images of small intestine and various structures around the abdomen and pelvis are seen. The test is conducted to determine extent of Fistula as well Crohn’s disease.
  • Colonoscopy: Before this test is conducted, the patient’s bowel should be completely empty. Done after applying general Anesthesia, a long and flexible instrument known as Colonoscopy is inserted through the rectum and taken to the large intestine. It allows the doctors to view the inner lining of the colon.
  • Lower GI Series: In this procedure the doctor uses x-rays coupled with barium to view images of large intestines. The application of barium makes the x-rays more prominent than usual. There are two types of tests: Single Contrast and Double Contrast.

Path to Cure

Most patients in India, under the influence of social taboos, think that their condition would be automatically healed. But, there is no such hope. In most scenarios surgical procedures can eliminate the problem and help the patient get back to normal pain free life. The type of surgery suggested by the doctor depends upon directions, depth and severity of the condition. There are many surgical options to cure fistula, these are:

  • Fistulotomy: This is the most widespread surgical option. In this procedure, the surgeon creates incision along the length of fistula and opens it up. When healed a flat scar is left behind. This treatment is applicable for causes where the fistula has not passed through much of the sphincter muscles.
  • Seton Technique: When the fistula is more severe than the above mentioned instance and it has significantly passed through the anal sphincter muscle, a piece of surgical thread (known as Seton) is left within the fistula to keep it open for several weeks. This helps in draining out of Pus and healing is attained over time. In this surgical technique there is no need to cut the sphincter muscles.
  • Advancement Flap Procedure: If the fistula has passed through the anal sphincter muscles and undergoing fistulotomy may hamper voluntary control over urination, then the advancement flap procedure is undertaken. In the procedure the fistula is cut out and the hole where it was entering the bowel is covered up with a flap-like tissue taken from the rectum. Though it avoids the need to cut the anal sphincter muscles, but it attains lower success rate than fistulotomy.
  • Bioprosthetic Plug: In some cases, where fistulotomy cannot be carried out, a cone shaped bio-prosthetic plug which is made of animal tissues is placed to block the internal opening of the fistula.
  • LIFT Procedure: LIFT (Ligation of the Intersphincteric Fistula Tract) is another surgical option when the fistulotomy is deemed too risky. In this surgery, an incision is made in the skin to separate the fistula and sphincter muscles. After this, the fistula is sealed from both the ends.
  • Fibrin Glue Method: This is the only non-surgical cure for anal fistula. A special glue is injected into the fistula, under general anesthesia. This glue seals and heals the fistula.

Life after Surgery

Most fistulas are completely cured after the surgery. However, after the surgery you might feel some discomfort in the affected area, so the doctor would prescribe painkillers. Apart from this, you would be advised to soak the incised area with warm water and take laxatives to soften the stool. Also, follow up visits to the doctor would be requested to detect the success of the surgery as well as any complexities that may arise.

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Injections For Knee Osteoarthritis & Their Facts

The best knee surgeons in Delhi NCR and India can offer a variety of treatments to relieve your symptoms. And of the most common treatments are inject medication into your knee. Some people find it painless and quickly effective whereas other people find them with full of side effects. The best thing is to know about before opting for it.

There are different types of injections, and they’re an important part of treating knee osteoarthritis for many people who are suffering severe knee issue. Injections can be especially helpful for people who haven’t gotten relief from NSAIDs like ibuprofen, or people who can’t take those drugs due to side effects.

What Is Osteoarthritis?

Osteoarthritis is a degenerative disease and a common form of arthritis that very often affects the joints, especially knees. It develops when the cartilage, the smooth covering that protects the bones in the joint breaks down. The surface of the bones becomes damaged, causing pain, swelling, stiffness, and disability. If it is not treated early and properly, it can cause immobility to the person and even sometimes so severe that the person can’t do their daily chores.

How Knee Injections Work

The first and foremost task is that your doctor will give you a shot of anaesthetic to numb your knee. He or she may use a needle to draw out any extra fluid that’s in or around your knee. After that, you’ll get the pain-relieving injection, usually just below your kneecap. Take care while having the shot though the inject will not hurt you, and the drug will work throughout the joint.

Different treatments have side effects that you should discuss with your doctor beforehand. The two most common types of knee injection for OA are Corticosteroids and Hyaluronic acid.

Reduce Inflammation With Steroids

Corticosteroid injections

Corticosteroid injections are more useful that the hyaluronic acid as it treats flare-ups of osteoarthritis pain and swelling with fluid buildup in the knee. These injections help relieve knee problem’s symptoms by reducing inflammation in the joint.

Surgivisor is presenting you some facts regarding the injection that you need to know:

  • They work fast and in a short span of time – usually within 24 to 48 hours.
  • The pain relief lasts from 6 to12 weeks, according to the intensity of your pain and its source.
  • Avoid using them more frequently. A corticosteroid shot often works best the first time and after that, they tend to give less relief.
  • Patients can use these shots two to three times a year. Using them too often may damage cells in the knee that make cartilage.

Hyaluronic Acid

Most of the fluid in a healthy knee is hyaluronic acid and to retain that, this injection is introduced. When the knee have started showing symptoms of knee osteoarthritis, the hyaluronic acid in your knee thins. This is why best knee replacement surgeon in Delhi NCR and India opt to inject more hyaluronic acid into your knee to boost the supply.

Thought this injection shot is not the first or traditional approach. But in some cases, they are suggested by the surgeons and doctors:

  • Your symptoms aren’t improved by pain-relief medications or non-drug treatments.
  • You can’t take other pain relievers.
  • A steroid shot doesn’t help enough.
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10 Best Exercises Helpful After Hip Replacement Surgery

Surgivisor advices you to begin your treatment or take any type of action after consulting with your hip replacement surgeon in Delhi, NCR and India. It is very important to consult with your physiotherapist and surgeon first because they will tell your immune system, level of hazard you have gone through with and time of recovery you will take. And only after these facts, the type of exercises will be recommended.

Though it is very important to exercise after surgery to increase the strength and flexibility in your new hip, it is also very important to know your body strength level first. Do you know that recommended exercises help to prevent blood clots? Yes, and this is why most of the orthopedic surgeons advice to do exercises as a necessary attempt. After hip replacement surgery, you may feel uncomfortable at first and a bit difficult but it will soon become normal like everyday activities sooner. You can increase the intensity of doing these exercises or can repeat repeat each one every day. Keep up the balance and repeat the exercises on both legs to make them equally strong and flexible. Do them slowly and with control.

Exercise 1: Increase Hip Flexibility And Strength

  1. Lie on your side with hips and knees bent and a pillow between your knees.
  2. Keep your feet together.
  3. Do not twist or use your back muscles.
  4. Lift the top knee off the pillow like a clam shell opening.
  5. Hold for a count of 3 to 5 and slowly lower the knee to the pillow. Repeat.

Exercise 2: Increase Hip Flexibility And Strength

  1. Lie on your side with the bottom leg bent to stop you from rolling onto your back.
  2. Keeping the top leg straight, lift it toward the ceiling making sure you do not roll forward or backward.
  3. Slowly lower the leg. Repeat.

Exercise 3: Increase Hip Flexibility And Strengthen Hips And Stomach Muscles

  1. Lie on your back with one leg bent.
  2. Tighten your stomach muscles and lift your bent leg being careful not to bend it more than 90 degrees.
  3. Keeping your stomach muscles tight, slowly lower the leg back to the starting position. Repeat. And discuss this exercise with your hip replacement doctors in Delhi, NCR and India.

Exercise 4: Strengthen Hips

  1. Lie on your stomach.
  2. Tighten your buttocks and lift one leg.
  3. Hold for a count of 3 to 5 and slowly lower your leg. Repeat.

Exercise 5: Increase Leg Flexibility And Strengthen Back Thigh Muscles

  1. Lie on your stomach with your legs straight.
  2. Bend one leg, lifting the heel toward your buttocks.
  3. Slowly lower your leg to the starting position. Repeat.

Exercise 6: Strengthen Front Thigh Muscles

  1. Sit in a steady chair and place an elastic loop around both ankles.
  2. Lifting your first foot, straight your leg while keeping the other foot on the floor as you stretch the elastic loop.
  3. Slowly lower your foot and return to the starting position. Repeat.

Visit surgivisor.com to know more about hip replacement cost in Delhi, NCR and India.

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