An anal fistula (also known as a fistula-in-ano) is an abnormal tunnel. It connects the inside of your anal canal to the skin around the anus. This tunnel typically starts at an internal opening and leads to an external fistula opening on the skin. Understanding your specific fistula in ano type is crucial. The exact path of the tunnel determines how complex your condition is. It also changes the symptoms you feel and the treatment you need.
At Best Fistula Treatment in Pune, India – Kaizen Fistula Care in Pune, we specialize in tracking these tunnels. Led by renowned colorectal surgeon Dr. Samrat Jankar, we offer advanced care for all types of fistula.
How Are Anal Fistulas Classified?
Specialists use a precise fistula classification system to plan your treatment. The absolute gold standard is the Parks Classification System. Created in 1976, it groups fistulas based on where they cross your sphincter muscles. These are the muscles that control your bowel movements. Surgeons also use Goodsall’s Rule during a physical exam. This rule helps predict the path of the tunnel based on where the external fistula opening is located:
- Anterior Openings: Openings on the front half of your body usually run in a straight line.
- Posterior Openings: Openings on the back half usually curve around toward the middle line.
The types of anal fistulas are:
The Parks system divides the condition into four primary anatomical types.
1. Intersphincteric Fistula:
An intersphincteric fistula is the most frequent type. It makes up about 70% of all cases.
- The Path: The tract starts inside the anus. It stays in the space between the internal and external sphincter muscles. It ends at an external fistula opening very close to the anus.
- Severity: It does not cross the voluntary external sphincter muscle. Because of this, it is usually a simple fistula. It carries a very low risk of muscle damage.
2. Transsphincteric Fistula:
A transsphincteric fistula is the second most common type. It accounts for about 25% of cases.
- The Path: The tract cuts directly through both the internal and external sphincter muscles. It usually opens on the skin an inch or two away from the anus.
- High vs. Low Variants: A low variant goes through only a tiny part of the muscle. A high transsphincteric fistula passes through the upper part of the muscle. It involves more than 30% of the muscle fibers. A high transsphincteric fistula requires highly precise care.
- The Horseshoe Variant: Sometimes, a trans sphincteric fistula tracks around the back of the anus in a U-shape. This severe form is called a horseshoe fistula. It often features openings on both sides of the body.
3. Suprasphincteric Fistula:
A suprasphincteric fistula is quite rare. It appears in only about 5% of patients.
- The Path: The tract travels upward from the internal opening. It loops completely over the top of the sphincter muscles. Then, it drops down through the pelvic floor to meet the skin.
- Severity: This is always a complex fistula in ano type. Traditional open surgery cannot be done here because it would damage the primary muscle structure.
4. Extrasphincteric Fistula
An extrasphincteric fistula is the rarest type. It accounts for only 1% to 2% of cases.
- The Path: This tract runs entirely outside the sphincter muscles. It actually starts much higher up in the rectum itself. It goes straight through the pelvic floor muscles to exit the skin.
- Why it Happens: It rarely comes from a basic gland infection. Instead, it is caused by Crohn’s disease, deep pelvic trauma, or complex surgical history.
5. Simple/complex fistula:
- ‘Simple’ Fistulas: Simple fistulas are typically intersphincteric or low transsphincteric fistulas involving less than 30% of the external sphincter. These fistulas have limited sphincter involvement, making them more amenable to treatment with sphincter-cutting procedures. Due to their less extensive nature, simple fistulas have a higher likelihood of successful healing with such procedures.
- ‘Complex’ Fistulas: Complex fistulas, on the other hand, have more extensive muscle involvement and may include anterior fistulas in female patients, recurrent fistulas, and those associated with preexisting fecal incontinence, inflammatory bowel disease, or radiation. Managing complex fistulas can be more challenging due to their complexity and associated risk factors. As a result, these fistulas are often treated with specialized and newer modalities that aim to preserve the sphincter function (sphincter-saving procedures) while effectively closing the fistula.
Why Choose Kaizen Fistula Care?
If you are dealing with chronic pain or constant drainage, do not wait. Consulting an experienced Fistula Specialist In Pune India is the right step. At Kaizen Fistula Care, we prioritize your comfort. We focus on modern, minimally invasive procedures to protect your body and speed up your recovery.
Take control of your health. Schedule a diagnostic consult with Dr. Samrat Jankar at Kaizen Fistula Care today.
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