Introduction
A fistula is a channel or duct connecting two organs or one organ to the skin surface. It is created artificially, for example during an inflammation. As a rule, it is used to drain off secretions, e.g. pus.
Especially common are anal fistulas, which start at the transition between the mucous membrane of the colon and the anal canal and move towards the skin around the anus. There are also fistulas that connect two intestinal loops with each other in the abdominal cavity or an intestinal loop with another organ. This can lead to pain.
Symptoms
Unfortunately, internal fistulas are unspecific in their symptoms. Sometimes they are completely asymptomatic. Typical symptoms, however, would be: Depending on the localization, further symptoms may occur.
Symptoms of anal fistulas are: Fistulas that connect two loops of intestine are often accompanied by the following symptoms: A fistula can also connect the intestine with the vagina or the bladder. In this case, the intestinal contents, i.e. stool and air, escape through the bladder or vagina. In addition, inflammation of the corresponding organs occurs, as bacteria can pass through the stool.
A clear symptom that speaks for a fistula at the navel originating from the intestine is the leakage of stool from the navel. Often, however, less clear-cut symptoms occur, which may indicate a fistula from the bowel, but do not yet prove it. The most common symptom is a purulent inflammation of the navel, which can manifest itself as pain, redness and a foul-smelling discharge from the navel.
In any case, such complaints at the navel should be clarified by a medical examination. Some fistulas do not connect two hollow organs with each other, but end blindly in the tissue. This causes them to form an abscess.
However, abscesses can also occur with fistulas that connect two hollow organs with each other. Very large fistulas, which connect the intestine with the skin, can also cause electrolyte shifts in the body.
- Fever attacks
- General lassitude
- Painful anal abscess or red, overheated swelling
- Itching
- Weeping spots in the anal region
- Building pain
- Digestive disorders
- Weight loss
- Palpable resistances in the abdomen
In rare cases, a fistula finds its way to the bladder and thus connects it with the intestine.
Among physicians, this is known as an enterovesical fistula. It represents a serious complication. The main symptom of an enterovesical fistula is pneumaturia.
This means that air from the intestine is released through the urine. Not only intestinal gases but also intestinal bacteria and stool enter the bladder through the fistula. On the one hand, this makes urination more difficult or painful, and on the other hand the bladder becomes more susceptible to inflammation.
By the intestine bacteria it can come so to a chronic urinary tract infection. This is accompanied by a burning sensation when urinating. This inflammation can spread further from the bladder, e.g. into the renal pelvis.
In the worst case, the bacteria enter the bloodstream. A life-threatening sepsis (blood poisoning) is the result. For this reason, a doctor should be consulted immediately if air or faeces is discharged via the urine.
A fistula of the urachus is a fistula of the urinary tract in which urine is discharged from the bladder via the navel.
- Cystitis
- Chronic inflammation of renal pelvis
The causes for the development of a fistula are manifold: Above all anal fistulas develop in the context of an abscess, a pus cavity in the anal region. A channel, a fistula, is formed so that the pus can drain from this cavity.
Fistulas are just as common in the context of a chronic inflammatory bowel disease as Crohn’s disease. Fistulas develop especially between the intestinal loops. Fistulas can also develop in the course of other inflammatory processes in the abdominal cavity.
Furthermore, cancerous ulcers can be the cause. Complications following surgery or organ endoscopy can also lead to the development of fistulas. Lastly, fistulas can be congenital in principle, without it being possible to identify a cause.
