Pre-Surgery Care for Anal Fistula: Safe Cleaning Practices

Preoperative Care for Fistula Surgery

Hello, Dr.
Ke.
My husband has an anal fistula and has already undergone drainage, with surgery planned for early February.
However, he has recently experienced some swelling and pain.
A friend of my mother-in-law, who practices homeopathy, suggested that during this time we could perform deep cleaning of the anus by manually removing feces from the anal opening to prevent it from getting stuck and causing inflammation or infection.
Is this a correct approach? If so, what would be the best way to clean it?

Karen, 30~39 year old female. Ask Date: 2020/01/13

Dr. Ke Fangxu reply Surgery

It is not personally recommended to do this as it poses a risk of damaging the sphincter and mucous membranes.
Those suggesting this are often not specialists in proctology.
If there are issues with constipation, increasing fiber intake and drinking more water is advisable.
If necessary, a stool softener can be used.
For issues related to swelling and pain at the wound site, topical ointments can be applied; however, it is important to have the surgical physician examine the area, as there is also a possibility of recurrence of anal fistulas.

Reply Date: 2020/01/13

More Info

When it comes to pre-surgery care for an anal fistula, particularly regarding safe cleaning practices, it is crucial to prioritize hygiene while avoiding any methods that could potentially cause harm or exacerbate the condition. The advice given by the alternative medicine practitioner to manually dig out fecal matter from the anal area is not recommended. This practice can lead to trauma, irritation, and even infection of the already sensitive area surrounding the fistula.

Instead, here are some safe and effective cleaning practices that can be followed:
1. Gentle Cleaning: After bowel movements, it is advisable to clean the anal area gently with warm water. You can use a handheld showerhead or a peri bottle to rinse the area. Avoid using harsh soaps or wipes that may irritate the skin. If you prefer, you can use mild, unscented soap, but ensure that it is thoroughly rinsed off.

2. Sitz Baths: Taking sitz baths can be beneficial. Soaking in warm water for about 15-20 minutes several times a day can help soothe the area, reduce inflammation, and promote healing. This practice can also help keep the area clean without the need for aggressive scrubbing.

3. Avoiding Manual Digging: As mentioned, manually digging out fecal matter can lead to more harm than good. Instead, focus on maintaining regular bowel habits to prevent constipation, which can lead to straining and further complications. A diet rich in fiber, adequate hydration, and possibly the use of stool softeners can help in this regard.

4. Use of Protective Barriers: If there is any discharge from the fistula, using a barrier cream or ointment can protect the surrounding skin from irritation. However, consult with your healthcare provider before applying any products to ensure they are appropriate for your condition.

5. Monitoring Symptoms: Keep an eye on any changes in symptoms, such as increased pain, swelling, or discharge. If the area becomes more painful or shows signs of infection (such as redness, warmth, or pus), it is essential to contact your healthcare provider promptly.

6. Consulting Healthcare Professionals: Always consult with your surgeon or healthcare provider regarding any cleaning methods or products you plan to use. They can provide personalized advice based on your specific situation and the condition of your fistula.

7. Avoiding Irritants: It’s important to avoid any products that may irritate the anal area, such as scented wipes, alcohol-based products, or any harsh chemicals. Stick to gentle, hypoallergenic options.

In summary, while maintaining cleanliness is essential for preventing infection and promoting healing in the case of an anal fistula, it is vital to do so in a safe manner. Avoiding invasive methods and focusing on gentle cleaning practices, such as warm water rinses and sitz baths, will be more beneficial. Always follow the guidance of your healthcare provider for the best outcomes.

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