Fistula: Difference between revisions

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* F'''istula''' is an abnormal connection between two hollow spaces such as blood vessels, intestines, or other hollow organs.  
=== Clinic ===
* Fistula is an abnormal connection between two hollow spaces such as blood vessels, intestines, or other hollow organs.
* Types of fistula can be described by their location.  
* Types of fistula can be described by their location.  
** Anal fistulas connect between the anal canal and the perianal skin.  
** Anal fistulas connect between the anal canal and the perianal skin.
** Anovaginal or rectovaginal fistulas occur when a hole develops between the anus or rectum and the vagina.  
** Anovaginal or rectovaginal fistulas occur when a hole develops between the anus or rectum and the vagina.
** Colovaginal fistulas occur between the colon and the vagina.  
** Colovaginal fistulas occur between the colon and the vagina.
** Urinary tract fistulas: An abnormal connection between the urinary tract and another organ such as between the bladder and the uterus in a vesicouterine fistula, between the bladder and the vagina in a  
** Urinary tract fistulas: An abnormal connection between the urinary tract and another organ such as between the bladder and the uterus in a vesicouterine fistula, between the bladder and the vagina in a
** Vesicovaginal fistula, and between the urethra and the vagina in urethrovaginal fistula.  
** Vesicovaginal fistula, and between the urethra and the vagina in urethrovaginal fistula.
** Enteroenteral fistula: When occurring between two parts of the intestine, it is known as an , between the small intestine and the skin as an enterocutaneous fistula, and between the colon and the skin as a colocutaneous fistula.
** Enteroenteral fistula: When occurring between two parts of the intestine, it is known as an , between the small intestine and the skin as an enterocutaneous fistula, and between the colon and the skin as a colocutaneous fistula.


Fistulas can result from an infection or inflammation, injury or surgery. Fistulas are sometimes surgically created as part of a treatment, for example arteriovenous fistulas for hemodialysis.


Treatment for fistula varies depending on the cause and extent of the fistula, but often involves surgical intervention combined with antibiotic therapy. In some cases the fistula is temporarily covered using a fibrin glue or plug. Catheters may be required to drain a fistula.
=== Signs and symptoms ===
* Skin maceration
* Pus, serous fluid and/or (rarely) feces discharge (Bloody/ Purulent)
* [[Pruritus]] / Itching
* Pain/ Tenderness
* Swelling
* Fever
* Unpleasant odor


Globally, every year between 50,000 and 100,000 women are affected by fistula relating to childbirth. In botany, the term is most common in its adjectival forms, where it is used in binomial names to refer to species that are distinguished by hollow or tubular structures. ''Monarda fistulosa'', for example, has tubular flowers. The term was first used in the 14th century.


== Definition ==
=== Note ===
A fistula is an abnormal connection between vessels or organs that do not usually connect. It can be due to a disease or trauma, or purposely surgically created.
* Most of its Sign / Symptoms are post-node due to the location. The only dynamic Sign / Symptom  is chronic inflammation which ends in chronic discharges and fistulation


* '''Disease:''' Infections including an anorectal abscess and inflammatory diseases including [[Crohn's disease]] and [[Ulcerative Colitis|ulcerative colitis]] can result in fistulas.
* Fistulas to the anus may occur in hidradenitis suppurativa.
* In women, fistulas can also occur following pelvic infection and inflammation.


=== Anal fistula ===
=== Miasms ===
 
* It is a chronic abnormal communication between the epithelialised surface of the anal canal and usually the perianal skin.
* An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. Anal fistulae commonly occur in people with a history of anal [[Abscess remedies|abscesses]].
* They can form when anal abscesses do not heal properly.


=== Signs and symptoms ===
* [[MTB, Mycobacterium tuberculosis|MTB]] <ref>Gupta PJ. Ano-perianal tuberculosis--solving a clinical dilemma. Afr Health Sci. 2005 Dec;5(4):345-7. doi: 10.5555/afhs.2005.5.4.345. PMID: 16615850; PMCID: PMC1831950.</ref>
* [[CMV, Cytomegalovirus|CMV]] <ref>Gill RS, Taylor G, Penner RM, Logsetty S. Enterocolic fistula: A rare presentation of cytomegalovirus infection. Can J Infect Dis Med Microbiol. 2012 Summer;23(2):e41-3. doi: 10.1155/2012/314384. PMID: 23730319; PMCID: PMC3403671.</ref>


* skin maceration
== Remedies ==
* Pus, serous fluid and/or (rarely) feces discharge — can be bloody or purulent
{| class="wikitable"
* Pruritus ani — itching
|+
* Pain
! colspan="2" |
=== [[Banerji protocols]] ===
|-
|'''First line'''
|
* [[Hyper, Hypericum Perforatum|Hyper]] C200 + [[Ars, Arsenicum Album|Ars]] C200, Two doses daily
* [[Psor, Psorinum|Psor]] C1000 one dose every 10 days
* Acute pain: [[Hyper, Hypericum Perforatum|Hyper]] C200 one dose every 2-3 hours
|-
|'''Second line'''
|
* [[Sil, Silicea|Sil]] C200 every 3 days
* [[Hep, Hepar Sulphur|Hep]] C200 + [[Ars, Arsenicum Album|Ars]] C200, two doses daily
|-
|'''Third line'''
|
* [[Psor, Psorinum|Psor]] C1000 one dose every 14 days
* [[CS, Tissue Salt Remedy|CS]]  6X, [[SIL, Tissue Salt Remedy|SIL]] 6X four doses daily
|}


:* swelling
=== [[Tissue Salt Remedies]] ===
:* tenderness
:* fever
:* unpleasant odor


* Thick discharge, which keeps the area wet
* [[SIL, Tissue Salt Remedy|SIL]]: Main remedy
 
* [[CP, Tissue Salt, Remedy|CP]]: Also may be needed
 
* [[CS, Tissue Salt Remedy|CS]]
=== Miasms ===
[[MTB, Mycobacterium tuberculosis|MTB]] <ref>Gupta PJ. Ano-perianal tuberculosis--solving a clinical dilemma. Afr Health Sci. 2005 Dec;5(4):345-7. doi: 10.5555/afhs.2005.5.4.345. PMID: 16615850; PMCID: PMC1831950.</ref>


[[CMV, Cytomegalovirus|CMV]] <ref>Gill RS, Taylor G, Penner RM, Logsetty S. Enterocolic fistula: A rare presentation of cytomegalovirus infection. Can J Infect Dis Med Microbiol. 2012 Summer;23(2):e41-3. doi: 10.1155/2012/314384. PMID: 23730319; PMCID: PMC3403671.</ref>
* [[CF, Tissue Salt Remedy|CF]]

Latest revision as of 04:20, 11 November 2023

Clinic

  • Fistula is an abnormal connection between two hollow spaces such as blood vessels, intestines, or other hollow organs.
  • Types of fistula can be described by their location.
    • Anal fistulas connect between the anal canal and the perianal skin.
    • Anovaginal or rectovaginal fistulas occur when a hole develops between the anus or rectum and the vagina.
    • Colovaginal fistulas occur between the colon and the vagina.
    • Urinary tract fistulas: An abnormal connection between the urinary tract and another organ such as between the bladder and the uterus in a vesicouterine fistula, between the bladder and the vagina in a
    • Vesicovaginal fistula, and between the urethra and the vagina in urethrovaginal fistula.
    • Enteroenteral fistula: When occurring between two parts of the intestine, it is known as an , between the small intestine and the skin as an enterocutaneous fistula, and between the colon and the skin as a colocutaneous fistula.


Signs and symptoms

  • Skin maceration
  • Pus, serous fluid and/or (rarely) feces discharge (Bloody/ Purulent)
  • Pruritus / Itching
  • Pain/ Tenderness
  • Swelling
  • Fever
  • Unpleasant odor


Note

  • Most of its Sign / Symptoms are post-node due to the location. The only dynamic Sign / Symptom is chronic inflammation which ends in chronic discharges and fistulation


Miasms

Remedies

Banerji protocols

First line
  • Hyper C200 + Ars C200, Two doses daily
  • Psor C1000 one dose every 10 days
  • Acute pain: Hyper C200 one dose every 2-3 hours
Second line
  • Sil C200 every 3 days
  • Hep C200 + Ars C200, two doses daily
Third line
  • Psor C1000 one dose every 14 days
  • CS 6X, SIL 6X four doses daily

Tissue Salt Remedies

  • SIL: Main remedy
  • CP: Also may be needed
  • CS
  1. ↑ Gupta PJ. Ano-perianal tuberculosis--solving a clinical dilemma. Afr Health Sci. 2005 Dec;5(4):345-7. doi: 10.5555/afhs.2005.5.4.345. PMID: 16615850; PMCID: PMC1831950.
  2. ↑ Gill RS, Taylor G, Penner RM, Logsetty S. Enterocolic fistula: A rare presentation of cytomegalovirus infection. Can J Infect Dis Med Microbiol. 2012 Summer;23(2):e41-3. doi: 10.1155/2012/314384. PMID: 23730319; PMCID: PMC3403671.
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