This topic was raised by a doctor-type on the forum I most frequently visit for news and local observations, in a list of infections that may well become common post-collapse—things like slivers under a fingernail, zits, gangrene, UTIs, an abscessed tooth, and ear infections. Like it was something common that everyone would know about.
Except I’d never heard of it before. And he said it may result from wearing dirty undies or not having toilet paper. And I can easily see that being an issue in the future. So it seemed like something to research.
None of my off-grid medicine texts mention it. One reason may be that it’s because there’s not a lot a lay person can do to treat it. There aren’t special supplies to store for a surgeon. However, there are preventative measures to take, and I sure as heck would want to know about them.
SIGNS AND SYMPTOMS
- Skin irritation around the anus
- Constant, throbbing pain that worsens with movement, sitting, defecation, or coughing
- Rectal bleeding or passage of pus with defecation
- Abscess formation near the anus
- High fever or chills
- Fatigue
- Fecal incontinence (uncommon)
Seek medical care immediately if an anal fistula is suspected.
RISK FACTORS
Most anal fistulas (about 50-75%) develop following an anal abscess, an infection of the anal glands located just inside the anal sphincter. These glands can become blocked and infected. If the abscess becomes larger, it may form a tunnel, or fistula, to the skin surface. Common chronic conditions that give rise to an anal fistula include colitis, Crohn’s disease and diverticulitis. A large tear through the anal sphincter during childbirth can also cause an anal fistula. Individuals with AIDS, HIV, STDs, rectal cancer, or tuberculosis are also at risk.
PREVENTION
- Consume a high-fiber diet, including whole grains, fruits, and vegetables.
- Drink plenty of water.
- Wipe gently—not vigorously—with soft toilet paper from front to back.
- Let the skin air dry after bathing.
- Avoid underwear that irritates the anal area.
- Avoid using scented panty liners or towelettes.
- Wear undyed cotton underwear.
- Refrain from anal sex.
TREATMENT
The anal fistula will not heal without treatment, except possibly for Crohn’s patients. The treatment is surgery, with the surgeon determining the exact procedure based on the location of the fistula. Management, before or after surgery, includes eating a high fiber diet, drinking plenty of fluids, and soaking in a warm bath 3-4 times per day. Use a stool softener or bulk laxative as needed.
COMPLICATIONS
- Without surgery
- Bleeding
- Fecal incontinence
- Pain
- Skin infections-cellulitis
- Sepsis
- Following surgery
- Infection
- Fecal incontinence
- Formation of another fistula
Anal fistulas occur most often around the age of 40 and are twice as common in men as in women. As surgery is the only treatment, and finding a colorectal surgeon and supplies may be difficult post-collapse, be sure to following all the preventative measures. Begin now with that high-fiber, whole grain diet.
Links to related posts:
Diverticulitis
References:
https://patient.info/infections/abscess-leaflet/anal-fistula
https://www.mayoclinic.org/diseases-conditions/anal-fistula/symptoms-causes/syc-20352871
https://healthlibrary.uwmedicine.org/Library/DiseasesConditions/Adult/Digestive/134,173
https://www.webmd.com/digestive-disorders/anal-fistula-overview
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211523/
https://www.hopkinsmedicine.org/health/conditions-and-diseases/anal-fistula
https://www.mayoclinic.org/diseases-conditions/anal-fistula/symptoms-causes/syc-20352871
https://www.healthline.com/health/how-to-clean-inside-your-bum#takeaway
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