Table of Contents
Rectal Fistula Definition
An abnormal opening in the wall of the RECTUM, often connecting the rectum with another structure such as the URETHRA (rectourethral fistula), the VAGINA (rectovaginal fistula), or the ANUS (anorectal fistula). Rectal fistulas may be congenital or acquired. Congenital fistulas often occur in combination with other congenital anomalies, notably those affecting the HEART such as tetralogy of Fallot (a collective of malformations in the structure of the heart).
Acquired rectal fistulas may be idiopathic (without detectable cause), though are more likely to occur in people who have inflammatory conditions that affect the gastrointestinal tract such as INFLAMMATORY BOWEL DISEASE (IBD). RADIATION THERAPY as treatment for PROSTATE CANCER, CERVICAL CANCER, OVARIAN CANCER, COLORECTAL CANCER, or other cancers in the abdomen can weaken the rectal wall, allowing fistulas to develop. As well, fistulas involving any portion of the gastrointestinal tract are frequent complications of HIV/AIDS.
Symptoms of Rectal Fistula and Treatment
Symptoms vary with the location of the fistula though often include FECAL INCONTINENCE or inappropriate presence of stool in the other involved structure. The diagnostic path may include DIGITAL RECTAL EXAMINATION (DRE), BARIUM ENEMA, and sigmoidoscopy (endoscopic examination of the lower COLON). Treatment is surgery to repair the fistula, which can sometimes be extensive when the fistula is long or deep. Potential complications vary according to the nature of the OPERATION necessary. In many people the surgical repairs end the symptoms and the person returns to his or her usual activities with no further problems. In some people, complications such as fecal incontinence arise or new fistulas occur.