World Journal of
Pharmaceutical and Life Sciences

A REVIEW ON CURRENT MEDICAL PARADIGMS PERTAINING TO THE MANAGEMENT OF FISTULA-IN-ANO

Dr. Preeti G. Verma*, Dr. Kamalakar V. Gajare

ABSTRACT

Cryptoglandular abscesses resulting from occluded and infected anal glands in the inter-sphincteric plane are the cause of anal fistulas. There are five grades and an incidence of 8.6 per 100,000. Anorectal fistulas can be brought on by foreign objects, radiation, infection, neoplasm, epithelialization, and distal obstruction. Obesity, diabetes, hyperlipidaemia, a history of surgery, salt consumption, smoking, and patients under 40 or with recurrent abscesses are risk factors. Imaging methods such as endo-anal ultrasound, CT pelvis, CT-fistulography, and pelvic MRI are crucial for diagnosis. The prognosis for anal fistulas varies; for sphincter-preserving procedures, the healing rate for simple fistulas is approximately 80%, while that of complex fistulas is approximately 60%. Up to 80–90% of setons have been successfully used; however, incomplete division, resection, or ligation can lead to failure. The gold standard for treating acute anal fistulas is fistulotomy, though there are other options. Reducing the number of procedures, customizing treatment for high-risk patients, educating patients about the risks of fecal incontinence, and obtaining preoperative imaging to more precisely classify fistulas are all important aspects of prevention.

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