Our Summary

This research paper reviews different treatments for Fistula-in-ano (FIA), a type of anal condition, in babies under two years old. The researchers looked at English-language studies from the past 25 years on the subject. They found 14 studies that met their criteria, which included 490 babies, mostly boys and mostly less than one year old. About 20% of these babies had non-surgical (conservative) treatment at first, and of these, 73% got fully better. However, 86% of the babies ended up having surgery. The most common type of surgery was fistulotomy, which had more repeat cases but fewer complications than another type of surgery called fistulectomy. In conclusion, while most of the studies reviewed looked at surgical treatments, non-surgical treatments were also quite effective. The type of surgery used also seemed to affect the likelihood of the condition returning and the risk of complications.

FAQs

  1. What is the most common type of surgery used to treat Fistula-in-ano (FIA) in babies?
  2. How effective are non-surgical treatments for Fistula-in-ano (FIA) in babies?
  3. Does the type of surgery used affect the likelihood of Fistula-in-ano (FIA) returning and the risk of complications?

Doctor’s Tip

A helpful tip a doctor might give a patient about anal fistula surgery is to make sure to follow post-operative care instructions carefully, including keeping the area clean and dry, taking prescribed medications as directed, and attending follow-up appointments to monitor healing and prevent complications. It is also important to maintain a healthy diet high in fiber and stay hydrated to promote bowel regularity and prevent strain on the surgical site. Finally, if any unusual symptoms or signs of infection develop, it is important to contact the doctor immediately for further evaluation and treatment.

Suitable For

Patients with anal fistulas are typically recommended surgery if they have recurrent or complex fistulas that do not respond to conservative treatments such as antibiotics or drainage. Surgery is also recommended for patients who experience symptoms such as chronic pain, recurrent infections, or fecal incontinence due to their anal fistula. Additionally, patients with underlying conditions such as Crohn’s disease or a weakened immune system may be recommended surgery to prevent complications or worsening of their condition. Ultimately, the decision to undergo anal fistula surgery is made on a case-by-case basis by a healthcare provider after considering the patient’s individual circumstances and symptoms.

Timeline

Before anal fistula surgery:

  • Patient may experience symptoms such as pain, swelling, discharge, and recurrent infections in the anal area.
  • Patient may undergo various tests and examinations to diagnose the condition, such as physical examination, imaging tests, and possibly a colonoscopy.
  • Patient may be prescribed medications to manage symptoms and prevent infection.
  • Patient may try conservative treatments such as antibiotics, sitz baths, and dietary changes to see if the condition improves.

After anal fistula surgery:

  • Patient undergoes the surgical procedure to treat the anal fistula, which may involve techniques such as fistulotomy, fistulectomy, or placement of a seton.
  • Patient may experience some pain, discomfort, and swelling in the days following surgery.
  • Patient will need to follow post-operative care instructions, such as taking medications, keeping the area clean, and avoiding strenuous activities.
  • Patient will have follow-up appointments with their healthcare provider to monitor healing and address any complications or recurrence of the fistula.
  • Patient may need to make lifestyle changes, such as improving hygiene practices and diet, to prevent future anal fistulas.

What to Ask Your Doctor

  1. What are the different surgical options for treating my anal fistula?
  2. What are the potential risks and complications associated with anal fistula surgery?
  3. How long is the recovery period after anal fistula surgery?
  4. Will I need to make any lifestyle changes or follow a special diet after surgery?
  5. How likely is it that the anal fistula will recur after surgery?
  6. Are there any alternative treatments or therapies available for anal fistula?
  7. How experienced are you in performing anal fistula surgery?
  8. Will I need to undergo any additional tests or procedures before surgery?
  9. What post-operative care instructions should I follow to ensure a successful recovery?
  10. Are there any long-term effects or complications associated with anal fistula surgery that I should be aware of?

Reference

Authors: Emile SH, Elfeki H, Abdelnaby M. Journal: Tech Coloproctol. 2016 Nov;20(11):735-744. doi: 10.1007/s10151-016-1536-1. Epub 2016 Sep 23. PMID: 27663698