Fistula or fistula disease has been well known to doctors since the beginning of medical science. There are different types of fistulas. The complexity of the duct depends largely on which layers of the rectum it penetrates or how deep it penetrates. There are different techniques and methods for treating different types of fistula. Patients think fistula is very likely to happen again in our country. Percentage I can't say. Due to which, when the patients hear about the operation, they say , " Sir, see if you can do it without operation, because how much more operation will you do, it will happen again." I have received several patients who have undergone surgery 1-3 times and even up to 5 times. Internationally, experts say there is a 5-10% chance of recurrence. What causes fistula and what causes it ? The origin of this disease is due to a special type of rectal infection. There are many glands inside the anus which cause boils due to infection. This boil ruptures at some point and comes out through a hole in the area around the anus and pus starts to come out. This infection causes a lot of pain in the rectum. The patient groans in pain all day. The pain subsides after the pus comes out. Fistula or fistula is the occasional pus coming out of one or more mouths on the side of the anus. Cancer of the rectum and inflammatory bowel disease and fistula. Fistula can also be caused by tuberculosis in the rectum. How many types of fistula ? Common fistula: It does not penetrate too deep into the rectal muscle, so treatment is easy. Complex fistula: There are different types of fistula and depending on how deep the umbilical cord has penetrated the flesh of the anus and how far it has reached the outer mouth by crossing the path of the friend. The treatment of these is really difficult. Then if this duct is more than one, then there is no point. The main obstacle to the operation of this disease is that the patient may lose the ability to hold the stool if he fails to perform the operation properly. What are the signs or symptoms of fistula ? There are basically three symptoms of this disease. Such as- 1. Swelling , II. Pain and 3. Discharge or discharge of pus and sticky substances. Most of the patients had earlier reported boils in the rectum. The boil inside is swollen and painful for air. When these rupture and some pus comes out of the mouth, the pain and swelling decrease. Discharge or pus is usually occasional. Sometimes the disease stays dormant for 2-4 months. Sometimes pus and mango are read with the stool. Because the problem is not constant, patients often think that they will get better. But after two or four months, when the same problem occurs again, he came to us again and said, "Sir, what can be done now ?" What are the tests required 1. Proctoscopy , sigmoidoscopy II. Colonoscopy 3. Barium X-ray 4. Fistulo Village: Can't contribute much. I think the most important thing is to examine the inside of the anus with your fingers. 5. Anal endosonography. Professor Dr. AKM Fazlul Haque Author: Colon and Anal Surgery Specialist , Founder Chairman Department of Colorectal Surgery Bangabandhu Sheikh Mujib Medical University , Dhaka. Chamber: Japan Baladesh Friendship Hospital (Pvt) Ltd. 55 , Sat Masjid Road , Dhaka Phone: 0172603116 , 01715071. Source: Daily Ittefaq , June 26 , 2009 Many people have a misconception about fistula disease that to perform a complex fistula operation , an artificial rectum ( colostomy) is required. I don't think there is a need for a complicated fistula operation. By the way , I have already operated on a few patients ; Who underwent two or three surgeries , including a colostomy ; But the operation failed. I operated on them without colostomy and they got better. However, there are some exceptional fistulas , for which colostomy is required, the number of which is very low. I have had colostomy for some of these fistulas in the last 9 years. Siton technology in complex fistula operations Hippocrates was the originator of the concept of this technology two and a half thousand years ago today. This technique involves cutting the rectal muscle very slowly. The cut is completed in two to three weeks. The muscles are tied with a rubber band or a Penrose drain tube. This technology causes inflammation locally , which prevents the muscle from moving away.