How to Diagnose Anal Fistula

How to diagnose anal fistula

To diagnose anal fistula the patient’s history (current diseases, past surgeries) is very important. Then, the diagnosis can usually be made by anal examination. The external mouth is investigated around the anus, after the external mouth is seen, a rectal touch (finger examination) should be made and the bulge line formed by the fistula on the breech wall should be felt by hand. When this line is rubbed, it can be seen that there is a yellow discharge from the outer mouth.

An anoscopic examination is required for the evaluation of the inner mouth, but we prefer imaging methods in order to reveal all aspects of the fistula line. In this sense, the most frequently applied method is Magnetic Resonance (MR) imaging. It is very important for us in terms of showing the presence of abscess in this region, the length of the fistula line, how many there are and its course (its relationship with the breech muscles). Sometimes, during MR imaging, imaging can be performed by administering drugs (contrast material) externally (MR fistulography).

Another method for determining the inner mouth is the examination performed under anesthesia. This examination, which is performed under general anesthesia, is for both diagnostic and therapeutic purposes, especially in patients with a complicated fistula.