What is the primary lesion of anal fistula?

The primary lesion of anal fistula is mainly perianal abscess caused by anal gland infection, which is the main cause of anal fistula. If the abscess formed after anal gland infection is not drained in time, it may rupture and form a fistula. Some external factors such as bad living habits and intestinal inflammatory diseases may also increase the risk of anal fistula. Effective treatment of anal fistula requires elimination of the infection focus and surgical repair of the fistula.

1. Perianal abscess caused by anal gland infection

Anal fistula is closely related to the structure and function of anal glands. Once an anal gland is infected, it is easy to develop into an anal abscess. If the abscess is not treated promptly and effectively, the pus will spread through the nearby tissues, rupture to form an external opening, and then connect to the anal canal to form a fistula. The treatment of perianal abscess requires drainage of pus as soon as possible to avoid the development of anal fistula. Anti-infection treatment is also required. Commonly used antibiotics include cephalosporins or quinolones.

2. Poor local hygiene and chronic irritation

Poor local hygiene is an important factor inducing anal gland infection. Moisture around the anus, excessive secretions, or inadequate cleaning after defecation will increase the risk of infection. To avoid infection, you should develop good hygiene habits, especially cleaning the anus after defecation. You can use warm water or a special cleaning solution for sensitive skin, and then keep it dry. Wearing loose, breathable underwear can help reduce the chance of local irritation.

3. Inducing effect of intestinal inflammatory diseases

Some inflammatory bowel diseases such as colitis or Crohn's disease can cause inflammation of local tissues in the anal canal, followed by the formation of abscesses or anal fistulas. Anal fistulas caused by these diseases are secondary anal fistulas, and the lesions are usually extensive. For this type of anal fistula, combined medical and surgical treatment is required. Drugs are usually needed to control the primary disease, such as aminosalicylic acid drugs (mesalazine) or immunosuppressants (azacitidine).

4. Trauma or other special factors

Trauma and postoperative infection may also lead to anal fistula. For example, improper rectal surgery may induce infection, causing abscesses and fistulas; repeated friction and stimulation caused by long-term constipation may damage the anal glands and cause infection. In these cases, the cause should be avoided as much as possible, and surgical incision and drainage and fistula repair should be performed if necessary.

If anal fistula is not treated promptly and effectively, it may cause serious complications such as multiple infections and repeated inflammation, and even affect the function of the anal sphincter. During the treatment process, surgery is the only way to cure it. Commonly used surgeries include fistulotomy, hanging thread therapy, and fistulectomy. During postoperative care, it is necessary to ensure wound hygiene and prevent postoperative infection. At the same time, adjust the diet structure and add high-fiber foods such as oats and cabbage to promote defecation.

Although anal fistula is an anal disease that cannot be ignored, most cases can be cured through timely detection and scientific treatment. When persistent swelling and pain, pus discharge, repeated infection, etc. are found in the anal area, it is recommended to seek medical treatment as soon as possible and face the disease with patience and correct methods to avoid repeated delays that may aggravate the condition.