What are the Six Methods for Diagnosing Anal Fistula?

The diagnosis of anal fistula can be made by combining the patient's clinical symptoms and through methods such as palpation, visual inspection, comprehensive examination, rectal digital examination, anoscopy, and others.

Common symptoms of anal fistula include recurrent breakdown and discharging pus near the anus, accompanied by itching. If the condition is mild, there may be no symptoms or only mild symptoms. In severe cases, patients may experience fever, shivering, and perianal pain.

In anal fistula, a cord-like hardness can be felt under the skin, running from the external opening to the anus. When pressed with a finger, pus may discharge from the external opening.

Around the anus or on the buttocks, a protrusion or depression can be seen at the external opening. Due to pus stimulating the surrounding skin, there is often peeling and red granulation tissue, sometimes visible from the external opening. Peripheral skin may appear reddish-purple, which is often indicative of tuberculous fistulas.

This mainly involves checking for any associated diseases, such as tuberculosis, sacroiliac tuberculosis, nonspecific ulcerative colitis, etc. Active tuberculosis patients often develop anal fistulas, and postoperative wound healing is slower. Sacroiliac tuberculosis may cause anal fistulas, possibly due to bone tuberculosis. Nonspecific ulcerative colitis may sometimes be complicated by anal abscesses, which, after rupturing, form anal fistulas. Patients with complex anal fistulas should undergo a comprehensive examination, including bacterial culture and antibiotic sensitivity testing if necessary, paying attention to changes in erythrocyte sedimentation rate and blood profile. Anal sphincter function tests can also be conducted. For some suspicious cases, a biopsy should be performed to determine the nature of the anal fistula, with special attention to the possibility of malignancy.

A small, centrally depressed hard nodule with mild tenderness can be felt near the posterior side of the anal canal and the dentate line, which is the primary internal opening.

This examination allows observation of whether the rectum is congested and hypertrophic, whether there is swelling, and whether pus discharge occurs when the fistula is compressed.

In summary, the above content describes six methods for diagnosing anal fistulas, which can help individuals better diagnose the condition and choose appropriate treatment methods. It is advisable to avoid spicy and irritating foods.