Anal fistula: A comprehensive review

2019 
Anal fistula is a chronic abnormal communication between the epithelialised surface of the anal canal and the perianal skin. It commonly occurs in people with a history of anal abscesses. Generally, improper healing of anal abscesses leads to anal fistula. Other causes include Crohn's disease, Diverticulitis, Hidradenitis suppurativa, infection with TB, constipation causing injury and infection in the crypts glands etc. The true prevalence of anal fistula is unknown. Breakdown of the epithelial barrier and associated immune cells of the anal mucosa leads to the formation of anal fistula. There are various surgical procedures viz seton, fistulotomy, Kshara sutra and sphincter saving methods available for treatment of anal fistula. Along with surgical procedures, Ayurvedic and Homeopathic medicines are available for the treatment of anal fistula. Numerous medicinal plants are reported to be useful in the symptomatic treatment of anal fistula.
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