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Anal fistula

Anal fistula, or fistula-in-ano, is an abnormal connection between the epithelialised surface of the anal canal and (usually) the perianal skin.

Source: Wikipedia

What are the symptoms?

Within all the people who go to their doctor with anal fistula, 71% report having pain of the anus, 33% report having blood in stool, and 33% report having sharp abdominal pain. The symptoms that are highly suggestive of anal fistula are pain of the anus, blood in stool, low back cramps or spasms, discharge in stools, mass or swelling around the anus, incontinence of stool, and mass in scrotum, although you may still have anal fistula without those symptoms.


What might my doctor prescribe?

Common Tests and Procedures

Patients with anal fistula often receive rectal examination, wound care management, pelvis exam, sigmoidoscopy or colonoscopy, other or lower gi therapeutic procedures, incision and drainage, colonoscopy and biopsy and other bowel diagnostic procedures .

Common Medications

The most commonly prescribed drugs for patients with anal fistula include metronidazole, psyllium, azathioprine, mesalamine (asacol), glimepiride, olmesartan (benicar), nitrofurazone topical, aztreonam, ginkgo biloba extract (ginkgo), cefotaxime, adalimumab (humira), bicalutamide (casodex) and hydrocortisone .

Metronidazole
$29
(14 days)
Psyllium
$11
(28 days)
Azathioprine
$28
(28 days)
Mesalamine (Asacol)
$300
(28 days)
Glimepiride
$8
(28 days)
Olmesartan (Benicar)
$74
(28 days)
Nitrofurazone Topical

Aztreonam
$787
(7 days)
Ginkgo Biloba Extract (Ginkgo)

Cefotaxime
$147
(7 days)
Adalimumab (Humira)
$1859
(28 days)
Bicalutamide (Casodex)
$98
(28 days)
Hydrocortisone
$21
(21 days)

Who is at risk?

Groups of people at highest risk for anal fistula include age 30-44 years, race/ethnicity = hispanic, age 45-59 years and age < 1 years. On the other hand, age 1-4 years almost never get anal fistula.

Age

< 1 years
1.9x
1-4 years
0.0x
5-14 years
0.2x
15-29 years
0.6x
30-44 years
1.8x
45-59 years
1.5x
60-74 years
0.6x
75+ years
0.7x

Sex

Male
1.5x
Female
0.7x

Race/Ethnicity

Black
0.5x
Hispanic
2.1x
White
0.9x
Other
1.2x
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