Can Digital Rectal Examination Accurately Diagnose Anal Fistulas?
Digital rectal examination (DRE) of the anus? Dear Doctor, can a digital rectal examination be sufficient for diagnosing anal conditions? Is the result from a digital examination always accurate, or is it safer to get checked at a larger hospital?
Dr. Zhang Shuhao Reply:
Experienced colorectal surgeons can diagnose anal fistulas in the clinic based on the location of the external opening, palpation, and anoscopy, achieving a high degree of accuracy that can serve as a basis for surgical intervention. Highly complex or recurrent fistulas may requi...[Read More] Can Digital Rectal Examination Accurately Diagnose Anal Fistulas?
Post-Surgery Care for Anal Abscess: What to Expect and Monitor
Postoperative condition after anal abscess surgery? Hello Dr. Ke: Last week on March 2nd, I underwent surgical drainage for an anal abscess at Haixian Hospital. The incision for drainage is quite small, about the size of a fingertip, approximately 1.5 cm. The incision is located ...
Dr. Ke Fangxu Reply:
1. It is likely that the infection has not completely healed; further observation is needed for a period of time, and it is currently uncertain whether it will develop into a fistula. 2. 2-4 weeks. 3. There are cases where a wound does not heal and directly develops into a fi...[Read More] Post-Surgery Care for Anal Abscess: What to Expect and Monitor
Challenges in Healing Anal Fistula Post-Surgery: A Patient's Journey
Postoperative non-healing of anal fistula? Hello, Doctor! Here is the background: My mother was diagnosed with rectal cancer around 2019 (very close to the anus). The first physician mentioned that the tumor was too close to the anal sphincter, which would necessitate a permanent...
Dr. Ke Fangxu Reply:
1. Low rectal cancer, after radiation therapy and surgery, has a high probability of developing a rectovaginal fistula. Once formed, it is difficult to heal because radiation therapy can affect local blood circulation, making the fistula less likely to close. 2. The discharge m...[Read More] Challenges in Healing Anal Fistula Post-Surgery: A Patient's Journey
Post-Surgery Care: Why Soaking is Allowed After Fistula Removal?
Postoperative sitz bath and irrigation issues? After general surgical procedures, doctors often advise patients to avoid getting the wound wet to prevent infection. However, after a fistula excision surgery, it is necessary to take sitz baths and rinse the wound. This is because ...
Dr. Zhang Shuhao Reply:
Wounds from anal surgeries, such as hemorrhoidectomy or fistula surgery, have different characteristics compared to wounds in other areas of the body. They are less prone to infection due to moisture or bacterial contamination (the exact reasons are not yet concluded, but it may ...[Read More] Post-Surgery Care: Why Soaking is Allowed After Fistula Removal?
Understanding Anal Fistula Surgery: Symptoms and Treatment Options
Fistula surgery, anal issues? Hello Dr. Chang: I started experiencing some pain during anal contractions from February 9th, which continued until February 12th and 13th when I began having severe pain during bowel movements. I also have a persistent sensation of wanting to have a...
Dr. Zhang Shuhao Reply:
The most common cause of severe pain during bowel movements is anal fissure, but lesions around the anus such as thrombosed hemorrhoids, perianal abscesses, and even anal fistulas can also cause varying degrees of pain when inflamed. When a doctor recommends surgery in an outpati...[Read More] Understanding Anal Fistula Surgery: Symptoms and Treatment Options
Understanding Anal Fistula Recurrence: Causes and Prevention Tips
Anal fistula Hello, Director Ke! I had a fistula excision surgery four years ago, and today I went for a consultation and confirmed that it has recurred, at the same exit point. Last time it was at the 7 o'clock position relative to the anus, and this time it is at the 5 o&#...
Dr. Ke Fangxu Reply:
Regarding recurrence, it is advisable to consult your attending physician. After anal fistula surgery, sitz baths are essential, and maintaining cleanliness is crucial.[Read More] Understanding Anal Fistula Recurrence: Causes and Prevention Tips
Post-Surgery Concerns: Managing Persistent Drainage Tube After Fistula Repair
Postoperative care after anal fistula surgery? Hello, doctor. I had an anal fistula surgery on November 8th last year, and there is still a white plastic tube protruding from the site that hasn't fallen out. Each time I return for a follow-up, the doctor pulls on it and ties...
Dr. Zhang Shuhao Reply:
This plastic tube is a special type of fistula treatment known as a "seton." It is used when the fistula passes through the high anal sphincter to avoid cutting too much sphincter muscle at once, which could lead to incontinence. As the plastic tube is gradually tighten...[Read More] Post-Surgery Concerns: Managing Persistent Drainage Tube After Fistula Repair
Understanding Post-Surgery Care for Fistula Excision: What to Expect
Fistula excision surgery Hello Dr. Chang, I underwent a drainage tube removal surgery on January 25th. I would like to ask about my recovery at home. On the fourth and fifth days post-surgery, the wound has shown less bleeding, but there is a layer of dark yellow discharge. Whe...
Dr. Zhang Shuhao Reply:
Typically, the yellow substance consists of old ointment and some sloughed tissue. If it cannot be scraped off, that's okay; continue with warm sitz baths and dressing changes, allowing it to fall off on its own. During the wound healing process, you may experience some pain...[Read More] Understanding Post-Surgery Care for Fistula Excision: What to Expect
Why Is My Stool Flat After Anal Fistula Surgery?
Post-operative changes in bowel movements resulting in flattened stools after anal fistula surgery? Hello, doctor. I underwent anal fistula surgery in early December last year, during which the doctor completely excised the fistula. I have been recovering well for over two months...
Dr. Ke Fangxu Reply:
After anal fistula surgery, it is possible to experience changes in the shape of the anus. If there is no discomfort or difficulty with bowel movements, there is no need for concern.[Read More] Why Is My Stool Flat After Anal Fistula Surgery?
Post-Surgery Concerns: Managing Anal Fistula and Polyp in Infants
Postoperative care for anal fistula surgery? Doctor, I would like to ask a couple of questions: 1. My baby had an anal fistula surgery at 4 months old, and during the healing process, a large polyp developed. When we took him to the doctor, the doctor removed it with a cotton s...
Dr. Zhang Shuhao Reply:
The polyp described in the text may be granulation tissue that has formed at the site of a wound. If it grows excessively, it can lead to an uneven appearance, so it is fine to remove it in an outpatient setting. Newly healed wounds tend to be more fragile and can easily bleed fr...[Read More] Post-Surgery Concerns: Managing Anal Fistula and Polyp in Infants
Post-Surgery Granulation Tissue Issues After Anal Fistula Repair
Abnormal granulation tissue formation after anal fistula surgery? Hello Dr. Chang, I apologize for bothering you again. Last week on January 16, I inquired about the healing time after anal fistula surgery (https://adoctor.tw/article/177648). In your response, you mentioned that ...
Dr. Zhang Shuhao Reply:
The formation of granulation tissue is a normal step in the wound healing process, so its growth is a sign of healing. It only needs to be trimmed if it grows excessively; otherwise, it will remodel on its own. Based on the photo, your wound is actually getting smaller and healin...[Read More] Post-Surgery Granulation Tissue Issues After Anal Fistula Repair
Can the External Anal Sphincter Be Reconstructed After Fistula Surgery?
Sphincterotomy Doctor, after undergoing fistula excision surgery, if the external anal sphincter has been severed, can the sphincter be reconstructed?
Dr. Zhou Hongzhang Reply:
Is it an anal fistula excision? You should consult a colorectal surgeon.[Read More] Can the External Anal Sphincter Be Reconstructed After Fistula Surgery?
Will My Sphincter Muscle Heal After Fistula Surgery?
Fistula surgery with sphincterotomy? I had a fistula surgery last week, and the fistula is less than one centimeter from the anal opening. After the surgery, I realized that the sphincter muscle was cut at the anal opening, and now it feels like a broken rubber band. Will the sph...
Dr. Zhang Shuhao Reply:
The anal sphincter is divided into the internal and external sphincters. In fistula surgery, to achieve a clean excision, a portion of the external sphincter is typically incised, but it is not completely severed, so bowel function should not be affected. However, due to changes ...[Read More] Will My Sphincter Muscle Heal After Fistula Surgery?
Understanding Anal Fistula Healing: Managing Complications and Care
The wound from the healing anal fistula has reopened? Hello Doctor, I have undergone three surgeries for anal fistula within five months: the first surgery on November 8, the second due to recurrence on December 1, and the third on January 17 of the following year. During my foll...
Dr. Zhang Shuhao Reply:
This is an initial healing epidermal tear that has reopened, exposing the underlying granulation tissue and causing bleeding. If the bleeding stops, you can continue to apply ointment and change the dressing to allow it to heal gradually. Although this is not an emergency situati...[Read More] Understanding Anal Fistula Healing: Managing Complications and Care
Post-Surgery Concerns: Understanding Pain and Scarring After Fistula Removal
Post-fistula surgery Hello doctor, I had a fistula excision surgery in mid-November last year, located between the anus and perineum, approximately in the circled area (https://imgur.com/a/6ilEKrR). I had follow-up visits with my surgeon at the end of December and again yesterday...
Dr. Ke Fangxu Reply:
Due to the unclear focus of the three photos and the lack of a personal examination, I cannot provide a definitive answer. However, it does not appear to be a recurrence or folliculitis; it may simply be pain from scar tissue after surgery. If there is no redness, swelling, heat,...[Read More] Post-Surgery Concerns: Understanding Pain and Scarring After Fistula Removal
Understanding Small Holes Near the Anus: When to Seek Medical Advice
There is a small hole near the anus? Hello, doctor. A month ago, I noticed a lump at the anal opening, and after visiting a clinic, I was diagnosed with an external hemorrhoid. After applying the medication, the swelling has subsided and there is no pain. However, during the trea...
Dr. Zhang Shuhao Reply:
An anal abscess can potentially lead to subsequent fistula issues, meaning that a small hole in the skin may be connected to the rectum. However, external hemorrhoids generally have no direct relationship with fistulas. If there is no swelling or pain and no purulent discharge up...[Read More] Understanding Small Holes Near the Anus: When to Seek Medical Advice
Understanding Healing Time After Anal Fistula Surgery: Key Insights
Healing time after anal fistula surgery? Last year, I posted twice inquiring about issues after anal fistula surgery. On 11/23, I asked about the recovery status after anal fistula surgery (https://adoctor.tw/article/176000) and on 11/27, I inquired about wound care after the fis...
Dr. Zhang Shuhao Reply:
The wound is much smaller than before and appears to be healthy. Sometimes, when the granulation tissue grows excessively and covers the surrounding skin, it may need to be slightly trimmed (usually done in the outpatient clinic using silver nitrate sticks or cryotherapy with liq...[Read More] Understanding Healing Time After Anal Fistula Surgery: Key Insights
Understanding Symptoms of a Hard Lump Near the Anus: Causes and Concerns
Anal mass There is a noticeable feeling of a hard lump internally near the posterior side of the anus (close to the coccyx). It hurts when walking, sitting, squatting, and during bowel movements, but there is no blood in the stool. What could this symptom indicate?
Dr. Zhang Shuhao Reply:
The most common causes of a painful hard lump on the posterior side of the anus are anal abscess or fistula. Sometimes, if the abscess is deeper, there may not be any visible skin changes, and in more severe cases, it can lead to fever. It is recommended to visit a colorectal cli...[Read More] Understanding Symptoms of a Hard Lump Near the Anus: Causes and Concerns
Post-Drainage Care for Anal Abscess: Preventing Fistula Formation
Anal abscess After an anal abscess incision and drainage, how should care be managed to prevent the development of a fistula?
Dr. Zhang Shuhao Reply:
The formation of a fistula after an abscess is related to the initial size of the abscess, the complexity of its course through the sphincter, the distance of the drainage incision from the anus, and the quality of wound healing. Postoperatively, it is important to avoid smoking,...[Read More] Post-Drainage Care for Anal Abscess: Preventing Fistula Formation
Understanding Anal Abscesses and Fistulas: Symptoms and Treatment Options
Anal abscess or anal fistula? Two weeks ago, after my menstrual period ended, I developed a lump near my anus that resembled a boil. I suspect it might be an anal abscess. A few days later, after applying medication, it healed within a day. I have a history of constipation, so my...
Dr. Zhang Shuhao Reply:
There is approximately a 40% chance that an anal abscess may develop into an anal fistula. Deeper anal abscesses may sometimes present with subtle surface symptoms, but they can still cause fever. To confirm the diagnosis, an examination in an outpatient setting is necessary. If ...[Read More] Understanding Anal Abscesses and Fistulas: Symptoms and Treatment Options