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FISTULA

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Anal Fistula Video

What is Fistula?
Obstetric fistula is the most devastating and serious of all childbirth injuries. It happens because most mothers in poor countries give birth without any medical help. So many are young girls. Complications from pregnancy and childbirth are among the leading causes of death and disability for women of reproductive age in these places.

 

Obstetric fistula was eradicated in the United States more than 100 years ago thanks to emergency cesarean section surgery.After enduring days of agonizing, obstructed labor a woman's body is literally broken by childbirth. During labor contractions, the baby's head is constantly pushing against the mother’s pelvic bone — causing tissue to die due to lack of blood flow to this area. All of that pushing creates a hole, or in medical terms a "fistula", between the birth passage and an internal organ such as the bladder or rectum. A woman cannot hold her urine, and sometimes bowel content as well.Her baby is unlikely to survive.

 

If she survives, a woman with fistula is likely to be rejected by her husband because of her inability to bear more children and her foul smell. She will be shunned by her community and forced to live an isolated existence. These women suffer profound psychological trauma resulting from their utter loss of status and dignity, in addition to suffering constantly from their physical internal injury. Fistula is a abnormal medical condition which results in the growth of un necessary passage ways between different organs which need not have been there in the first place. fistulas can develop almost anywhere inside the body and between any two organs. although in most cases it is not much of a complication and can be easily treated using medication and surgery. However precautions and treatment not taken at the right time might lead to problems like infection and even cancer at times.
Some of the Places Fistula might Develop include
 1. salivary gland
 2. stomach
 3. duodenum
 4. appendix
 5. anal
 6. rectal fistula
 7. intestinal fistula
 8. gall bladder fistula
 9. bile duct fistula buy adderall from online pharmacy

Types of Fistula:
Fistula are divided into three broad categories according to the physical features and type of connections shown by the fistula

1.blind(one open end )
 2.complete (external and internal openings)
 3. incomplete (something that does not connect to any internal organ) custom paper
Fistula is also classified according to the place of existence of fistula. Here the name refers to the place where the fistula can be found
 1.vaginal fistula
 2.rectal fistula
 3.anal fistula
 4.lacrimal fistula
 5.mastoid fistula
 6.bladder fistula
Fistula occurs in various places around the body so there causes are also varied and cannot be generalized.
However some common causes of fistula include
1. diseases ( several inflammatory diseases like crohns disease and ulcerative colitis.)
2. medical treatment( radiation therapy and gallbladder surgery can cause fistula)
3. trauma caused by injury specially head injury and even rape.
In medicine, a fistula (pl. fistulas or fistulae) is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect. It is generally a disease condition, but a fistula may be surgically created for therapeutic reasons.
Without treatment, fistula often leads to social, physical, emotional and economic decline. Although some women with fistula display amazing courage and resilience, many others succumb to illness and despair.

 

The misery of fistula is relentless. In spite of one's best efforts to stay clean, the smell of leaking urine or faeces is hard to eliminate and difficult to ignore. The dampness causes rashes and infections. The cleaning up is constant, and pain or discomfort may be continuous as well. The grief of losing a child and becoming disabled exacerbates the pain. The courage many women show in the face of these challenges is extraordinary.
The injury leaves women with few opportunities to earn a living, and many have to rely on others to survive, or turn to begging or commercial sex. In some communities they are not allowed to have anything to do with food preparation and may be excluded from prayer or other religious observances. Although many women with fistula have supportive families, the smell can drive even loving husbands and friends away. For many women, the profound social isolation is worse than the physical torment.
The pain and loneliness associated with fistula is often compounded by a sense of shame and humiliation. In some communities, the condition is seen as a punishment or a curse for an assumed wrongdoing, rather than as a medical condition.

Anal Fistula?
A fistula in ano is a tunnel like- pipe like track, developed in the perennial region, usually having one or more external openings around the anus leading to an internal opening in anal fistula, fistula in ano, rectal vaginal fistula, anal fistula plug, anal fistula treatment, ano rectal fistula, rectal fistula, anal fistula pictures, enfermedad del ano rectal fistula com, fistula en ano, Bhagandara, ksharsootra, kshar sutra treatment, Ksharsutra treatment, Ksharsootra - medicated setone, laser surgery, radio surgey, Proctoscopy, Sigmoidoscopy treatment in gujarat, india, asia.the mucosa of the anal canal or the rectum. Anal fistula is termed "Bhagandara" in Ayurveda. In Ayurveda fistulas, like other diseases have been classified according to the vitiation of one per more of the three doshas i.e. the vata, the Pitta & the kapha. They have been classified also according to the shape & site of the track of the fistula. Special treatment for such different kinds of fistulas is mention in detail. It is worth noting that the complex & most challenging horse shoe fistula ( complex Ischio-rectal fistula) has been dealt with in detail in Sushruta a classical Ayurveda text) even as early as 300 ad.The Ksharsutra treatment was probably first advised per this type of fistula named Parikshepi Bhagandara by Sushurta. This Ksharsootra treatment, with a little modification has proved its worth even in modern times.Anal fistula, a rare condition, is a chronically inflamed, abnormal tunnel between the anal canal and the outer skin of the anus. It often drains watery pus, which can irritate the outer tissues and cause itching and discomfort.

Symptoms of Fistula
Symptoms of anal fistula may include
A patient of fistula in ano often suffers from a recurrent, small or large boil/boils/abscess surrounding the anus, accompanied with pain, discomfort & pus/blood discharge. The symptoms subside when the boil / abscess burst spontaneously causing some more discharge for a couple of days. The boil / abscess "heals up" temporarily but almost always reappears after some times.

 

Itching, discharge of watery pus, irritation of tissue around the anus, discomfort & pain these are the main symptoms of the fistula in ano
Some of the most Common Symptoms of Anal Fistula Include

 1. Throbbing pain ,itching and discomfort in the regions in and around the anus.
 2. Abscess releases watery puss or mucus which is stained with blood.
 3. Repeated bouts of fever
 4. Diarrhoes
 5. Loss of apetite
 6. Weight loss
 7. Nausea
 8. Vomiting
Several Diagnosis test need also be taken in order to completely come to the conclusion that its fistula.
They Include
 1.anoscope
 2.biopsy
 3.ultrasound

Causes of Fistula

  

A rectovaginal fistula may form as a result of:
Injuries in childbirth.
Obstetric injuries are the most common cause of rectovaginal fistulas. Such injuries include tears in the perineum that extend to the bowel or an infection or tear of an episiotomy — a surgical incision to enlarge the perineum during vaginal delivery. These may happen following a long, difficult labor. Fistulas arising from childbirth may also involve injury to your anal sphincter, the rings of muscle at the end of the rectum that help you hold in stool.
Crohn's disease.
The second most common cause of rectovaginal fistulas, Crohn's disease is a type of inflammatory bowel disease in which the lining of your digestive tract becomes inflamed. Most women with Crohn's disease never develop a rectovaginal fistula, but having Crohn's disease does increase your risk of the condition.
Surgery involving your vagina, perineum, rectum or anus.
Prior surgery in your lower pelvic region, such as removal of your uterus (hysterectomy) in rare cases can lead to development of a fistula.
Cancer or radiation treatment in your pelvic area.
A cancerous tumor in your rectum, cervix, vagina, uterus or anal canal can lead to development of a rectovaginal fistula. Radiation therapy for cancers in these areas can also put you at risk of developing a fistula. A fistula caused by radiation usually forms within two years following the treatment. Before the fistula forms, you may experience pain in your anus or rectum, bloody diarrhea, or bright red blood in your stool. If you spot these warning signs, your doctor will first rule out a return of cancer as the cause.
Other causes.
Less commonly, a rectovaginal fistula may be caused by infections in your anus or rectum; infections of small, bulging pouches in your digestive tract (diverticulitis); or vaginal trauma.

Risk Factors for Fistula
Risk Factors of Fistula Include the following:

 

• Inflammatory bowel disease such as Crohn's disease may cause both anal fistula and perirectal abscesses. An anal or rectal abscess may also be caused from diabetes immunosuppression, pregnancy and ulcerative colitis.

• Complications such as Crohn's disease, trauma, radiation therapy or chemotherapy may develop the Rectovaginal fistula.

• Life style may also contribute in the development of fistula such as inactivity, stress diet, and aging.

• Behaviors such as sex, smoking, alcohol, drugs may develop the fistula.

• Obesity, cholesterol, diabetes, hypertension may develop the fistula.

• Diseases such as HIV, heart problems0, cancer, autoimmune, immunocompromise may cause the fistula.

• Infections caused by animals, birds, insects, water, travel may develop the fistula.

• Factors such as environment, occupation, sunlight, radiation, chemicals may cause the fistula.

• Some of the medications, contraceptives, steroids may cause the fistula.

• Pregnancy, childbirth, menopause may cause the fistula.

Complications of Fistula
Complications of the Fistula include the following:

• Blockage of the urinary catheter, infection, anuria and most of this can be managed effectively but in rare cases a patient dies.

• Women with fistula tend to be malnourished and may be more susceptible to disease.

• Pancreatic Fistula (PF): This fistula is regarded as a serious complication both in terms of frequency and sequelae.

• Peoples with untreated pulmonary arteriovenous fistulas will develop a paradoxical embolism here a blood clot travels from the lungs to the arms, legs, or brain (if it travels to the brain, it can produce a stroke).

 

Heart failure.
This is the most serious complication of large arteriovenous fistulas. Since your blood flows more quickly through an arteriovenous fistula than it would if your blood flowed through a normal course of arteries, capillaries and veins, your blood pressure drops and your heart pumps harder to compensate for the drop in blood pressure. Over time, the increased intensity of your heart's pumping can weaken your heart muscle, leading to heart failure.
Blood clots.
An arteriovenous fistula in your legs can cause blood clots to form, potentially leading to deep vein thrombosis, a painful and potentially life-threatening condition if the clot travels to your lungs (pulmonary embolism). Depending on where your fistula is, it can lead to a stroke.
Leg pain.
An arteriovenous fistula in your leg can also cause you to develop pain in your legs (claudication), or can worsen pain you already have.

Prevention of Fistula 
Prevention comes in the form of access to obstetrical care, support from trained health care professionals throughout pregnancy, providing access to family planning, promoting the practice of spacing between births, and supporting women in education and postponing early marriage. Fistula prevention also involves many strategies to educate local communities about the cultural, social, and physiological factors that condition and contribute to the risk for fistula.

 

One of these strategies involve organizing community-level awareness campaigns to educate women about prevention methods such as proper hygiene and care during pregnancy and labour[citation needed]. Prevention of prolonged obstructed labour and fistula should preferably begin as early as possible in each female’s life. For example, improved nutrition and outreach programs to raise awareness about the nutritional needs of female children to prevent malnutrition as well as improve the physical maturity of young mothers, are important fistula prevention strategies.

 

It is also important to ensure access to timely and safe delivery during childbirth; measures include availability and provision of emergency obstetric care as well as quick and safe caesarean sections for women in obstructed labour. Midwives located in the local communities where fistula is prevalent can also contribute to promoting health practices that help prevent future development of obstetric fistulas. Promoting education for girls is also a key factor to preventing fistula in the long term. There are currently several organizations that have developed effective fistula prevention strategies. One of them is the Tanzanian Midwives Association, which works to prevent fistula by improving clinical health care for women and delaying early marriages and childbearing years, as well as help the local communities advocate the rights of females.

Treatment of Fistula
Anal fistulas are serious complications and as compared to other kind of fistulas and they never heal by themselves. The most popular method of treatment of fistula is Herbal Treatment. Once treated the fistula should heal and produce no long-term problems, provided there is no underlying cause. An anal fissure is a superficial linear tear in the anoderm most commonly caused by passage of a large, hard stool. This tear is distal to the dentate line. Anal fissures are among the most common anorectic disorders in the pediatric population; however, adults also are affected. The 4 categories of fistulas, based on the relationship of fistula to sphincter muscles, intersphincteric, transsphincteric, suprasphincteric, extrasphincteric.

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