What causes a fistula. Fistula - where it can occur and how to treat it

What is a fistula? AT medical practice it is often called a fistula. This word translated from Latin means "pipe". A fistula is a kind of channel or tube that connects an abscess or tumor to the surface of the body or two organs (two cavities) to each other. Through fistulas constantly pass liquid discharge, so they practically do not heal on their own and can exist for quite a long time. long time. Let's try to figure out where they come from and how they are treated.

Types of fistulas depending on location

There are several different classifications fistulas. Most often they are distinguished by their position in the body:

• Purulent fistulas are located on the surface and are intended for the outflow of purulent discharge from the focus of the inflammatory process. Sometimes it happens after poor quality treatment teeth, if the focus of inflammation remains untreated, and the tooth is closed with a filling. It happens that the inflammation goes away on its own, the suppuration stops, and then the fistula can drag on. But this is rare, more often they open again and again. If such a fistula does not heal for a long time, over time it can lead to amyloidosis and protein depletion.
• Urinary fistulas develop on bladder, ureters and urethra. Their cause is trauma. Sometimes they are created artificially.
• Gastric fistulas are created artificially for enteral feeding of patients.
• Fistulas on upper section of the small intestine most often occur as a complication after trauma or surgery. Given that proper care they heal themselves.
• Fistula in the lower section small intestine form in an operative way with intestinal obstruction or with peritonitis to remove intestinal contents.
• Biliary fistulas also often occur as complications after surgical intervention. The release of bile from the bladder provokes damage to tissues in contact with it, as well as a violation fat metabolism. Therefore, such fistulas should be treated immediately.
• Fistulas in the large intestine are both artificial, arising after operations, and developed after injuries. They require the use of protective ointments, as feces can pass through the fistula and injure the skin. But such fistulas often heal on their own.
• Salivary fistulas occur due to inflammatory processes in the cheek, ear or neck. In this case, saliva is secreted through the fistula.
• Bronchial fistula is a pathological communication of the bronchus with the pleural cavity.

Photo gallery of fistula types

Classification of fistulas on other grounds

In addition to location, fistulas differ in origin and in their communication with environment. These features are also used for classification.

Depending on the origin, they are divided into:

• Acquired - resulting from suppuration. They form on the gums with untreated teeth, chronic periodontitis, and also with such serious illnesses like osteomyelitis or tuberculosis.
• Congenital - arising from malformations.
• Artificially created by surgery or trauma.

External fistulas may look like pustules or sores on the skin

Depending on their contact with the environment, all fistulas are divided into:

• External, which go to the skin.
• Internal, connecting adjacent body cavities.

In addition, fistulas can be classified according to the nature of the secret secreted from them - purulent, bile, mucous, fecal, urinary, etc.

Symptoms of the disease

How this disease will manifest itself primarily depends on where the channel is located and what is the reason for its appearance. If we are talking about an external or external fistula, then it will look like a hole in the skin from which fluid oozes. The appearance of a fistula may be preceded by trauma to the area, inflammation of nearby organs and tissues, or surgery.

It is not easy to determine the presence of a fistula, this should be done by a doctor, for example, a dentist with a fistula on the gum

Internal fistulas usually appear after chronic or acute diseases certain organs. For example, biliary can develop after flow obstruction by a pebble. The severity of symptoms in this disease will depend on the amount of bile secreted. If it is large enough, the patient will feel severe pain accompanied by indigestion.

Many physicians claim that fistulas are a local expression of a constitutional defect. Therefore, it is necessary not only to heal the fistula, but to look for its deeper cause and get rid of it.

With bronchoesophageal fistulas, food often enters the tracheobronchial tree. This leads to bronchitis and aspiration pneumonia. With a fistula of the rectum, a hole in the skin near the anus. Often seen copious excretion pus and severe pain in the anus.

A fistula on the gums is accompanied by toothache, aggravated by touch, tooth mobility, and purulent discharge.

Diagnostic methods

If you suspect that you have a fistula, you should immediately go to the hospital, as the success of treatment often depends on the speed of its onset. But before carrying out therapy, it is necessary to correctly diagnose. The doctor must collect an anamnesis, the patient's complaints, if possible, examine the composition of the discharge and its volume. It is also necessary to analyze the change in the functioning of the body.

To determine the position and size of the fistula, the most modern methods research

To clarify the direction and length of the fistulous canal, as well as its connection with the focus, x-rays are used with the introduction of a contrast agent and probing. External fistulas are much easier to diagnose, since the doctor has the opportunity to examine them naked eye. When studying internal fistulas, use ultrasound procedure, endoscopy and radiography.

Fistula treatment

Treatment of a fistula depends on its location and origin. With external fistulas, patient therapy is based on local treatment, operational and general therapeutic. Local therapy- this is the treatment of the wound itself and the protection of the surrounding tissue from the fluid released from the canal. It is carried out with the help of ointments, pastes and powders. They are applied near the external opening of the fistula, protecting the skin from exposure to pus and mucus.

Often surgery is required to treat fistulas.

Also often used drugs that neutralize the discharge from the fistula. In this way, the irritating effect of the discharge on the skin is excluded. For this purpose, inhibitors of proteolytic enzymes are used: for example, "Kontrykal" or "Gordox". Also apply mechanical methods skin protection. First of all, they are aimed at stopping the discharge from the fistula with the help of special devices.

If the fistula exists long enough, its walls become a secreting membrane and can no longer grow together. In such cases, they must be excised and the edges of the wound fused.
The general treatment of purulent and some other fistulas involves their constant washing. antiseptic solutions. To treat tubular granulating passages, it is often sufficient to remove the cause of their development. After removal of the ligature or bone sequester, they often close on their own. If the fistula was created surgically to solve a problem, for example, to remove pus or feed the patient, then it is usually also closed with the help of an operation.

Fistula- an inflammatory channel characterized by the formation of purulent secretions. The channel is formed only when there are no other ways to exit purulent clots. Almost no one is immune from the formation of fistulous canals. However, today there are a number of effective methods aimed at the treatment and prevention of this phenomenon.

Causes of a fistula

Considering the causes of the formation of fistulous canals, this phenomenon can be divided into two ways of occurrence:

Congenital;

Acquired.

Congenital fistula is most likely an abnormal phenomenon, a consequence of improper development and activity of the body. Often a congenital fistula is formed in the neck, it can also form near the navel.

Acquired fistula is a consequence of the inflammatory process. Also, the cause of this education can serve as a surgical intervention. In turn, acquired fistulas are classified into external and internal.

External fistulas come to the surface of the skin, for example, a fistula of the rectum. With the development of an internal fistula, the nodes of the tubule do not come into contact with external environment, but are formed inside the tissues, for example, bronchoesophageal fistula.

In infants, an umbilical fistula is common. You can detect this pathology even at the stage of pregnancy, during an ultrasound scan.

Abscess rupture can lead to anal fistula. This is a fairly common occurrence and proper treatment the fistula is eliminated in a couple of weeks. However, this is not always practiced. fast way fistula removal. In a more complicated form anal fistula stretches, and the treatment time reaches several years.

A rectovaginal fistula is formed when pathological childbirth. It can be prolonged labor, postpartum trauma, which can lead to the formation of a rectovaginal fistula. Often, during childbirth, surgical intervention is necessary, which can also cause the development of pathologies in the expectant mother.

Pararectal fistula - a tubule connecting the focus of the disease with any part of the body or with internal organ. Often, fistulas of this kind are also formed between two inflamed organs. Also rescheduled acute paraproctitis may contribute to the development of pararectal fistula.

A fistula on the coccyx is a common occurrence in men, who are characterized by abundant hairline. Also, an injury in the sacral region can provoke the formation of this type of fistula. Often meets postoperative fistula, which is a consequence of a violation of blood circulation. The formation of a fistula can be facilitated by an infection, improperly treated sutures and wounds.

The most dangerous type of fistula is fistula duodenum. The cause of the disease can be surgical interventions based on abdominal cavity. Quite often fistula of a duodenum comes to an end with a fatal outcome.

Fistula symptoms

Based on the foregoing, we can say that a fistula can affect any cavity and organ. That is why it has a very blurred symptomatic picture. It all depends on the area where the pathology develops.

The first symptom that indicates the formation of a fistula is a hole in the skin. The patient may also note the release of fluid from the hole. In some cases, even the patient himself cannot explain the reason for the appearance of this hole. Often, minor trauma can lead to the development of a fistulous canal.

As for internal fistulas, which do not appear as holes in the skin, they are the result of chronic diseases. For example, a biliary fistula may be the result of finding stones in the bladder. Pain in the abdominal cavity will be noted, the severity depends on the amount of fluid released. Digestive disorders, general weakness of the body can also form.

With the development of bronchoesophageal fistulas, the patient may develop bronchitis and even pneumonia.

The patient will not be able to detect the internal fistula on his own. Only a qualified doctor, after conducting a series of tests and examinations, will be able to establish the exact cause of the occurrence of such symptoms in a patient.

Fistula diagnosis

The doctor will be able to diagnose a fistula without problems, only if the patient has an external fistula. Here he carefully examines the patient, reveals the amount of fluid released from the hole. The cause of the fistula should also be identified. It should be understood, trauma, or surgical intervention led to the formation of fistulous tubules.

With the development of internal fistulas, the scale of the canal and the level of organ damage should be considered here. Without special survey it is impossible to understand in which organ the fistulous growth occurred. Often, X-ray, probing, endoscopy and ultrasound are used for diagnosis.

Fistula treatment

When considering the issue regarding the treatment of fistula, it is necessary to understand that the only way to eliminate pathologies - surgical intervention. Departing from the area of ​​development of the fistulous canal, you should contact a specialized specialist who will assess the severity of the situation and be able to select a number of effective methods on the road to recovery. For example, if there is a fistula of the gums, then the dentist should deal with the treatment of the purulent canal.

It is necessary to start treatment of the fistulous canal immediately after the discovery of a hole in the skin. You should not be afraid of doctors and wait until the wound resolves itself. It can be confidently stated that the purulent canal not only will not disappear by itself, but can also be stretched, covering new areas. And in this case, you may need to consult not with one specialist, but with several doctors who will assess the scale of the fistulous lesion.

In some cases, the formation of a fistulous canal does not cause any pain and discomfort. However, surgical intervention is still necessary, the fistulous canal should be removed. Otherwise, purulent lesions can affect other organs, and the affected area may also include joints, kidneys, and heart. Cases have been identified where the fistula was the cause of the formation of tumors.

In the treatment of fistula, anti-inflammatory therapy is also used, especially if we are talking about purulent discharge.

Fistula prevention

The most important thing in the prevention of fistula is the prevention of development infectious diseases. Considering the above reasons for the development of a fistula, we can say that the operations performed often lead to the development of a fistulous canal. This suggests that it is necessary to comply with all the recommendations and requirements of doctors regarding the postoperative behavior of the patient. Hygiene measures should not be neglected, but dressings should be performed in a timely manner, as well as a special postoperative diet should be observed.

The most common is fistula of the gums. Most people, despite the use of the latest equipment in medicine and painless methods of dental treatment, are still afraid to go to the dentist. This neglect is what causes fistulous canals to appear.

You should also take care of your immunity. It is immune weakening that leads to the development of many diseases. The entry of infectious bacteria into the body can lead to internal fistulas, and it can be extremely difficult to identify them.

Attention to your health and nutrition are the main measures to prevent fistula.

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Fistula of the rectum (medical name - fistula) - a through tubular canal that connects the abdominal organs. From the inside, the fistula is lined with epithelial cells or "young" connective fibers, which form as a result of tightening and healing various wounds and local tissue defects. Approximately 70% of rectal fistulas form in the pararectal space and extend from the Morganian crypts (pockets open towards the movement of stool) to the skin. Anorectal fistulas go from the anus directly to the skin.

Treatment of rectal fistulas usually involves the use of surgical methods, as well as mechanical and chemical cleaning of the cavity. Very often, patients diagnosed with purulent rectal fistulas are interested in whether a fistula can be cured without surgery. Experts agree that the treatment of pathology with medication and folk methods is ineffective and can only be used as auxiliary component to accelerate regenerative processes and quick recovery damaged tissues. There are also ways to excise the fistula without surgical (invasive) intervention, so the patient must be able to complete information about everyone available methods therapy.

Most proctologists consider surgery the most effective method of treating various fistulas, since during the operation the doctor can remove all damaged tissues, which significantly reduces the risk of recurrence. Fistula excision with a scalpel is an invasive, highly traumatic operation that requires a long recovery period, so many patients are looking for ways to treat fistulas without surgery. They will be discussed below.

Laser treatment without surgery

This is one of the safest, most effective and least traumatic methods of treating fistulous tracts, which has several advantages. Even children and adolescents can be treated with laser when indicated, although some doctors advise against using this technique in children under 10 years of age. Impact laser beams does not cause discomfort and pain, and after the procedure there is no need for a rehabilitation and recovery period. After excision of the fistula with a laser, there are no scars and scars on the skin, which is important if the operation is performed in the anorectal zone.

In spite of a large number of Pluses, laser treatment has significant disadvantages, including:

• high cost (in different clinics the cost can vary from 20,000 to 45,000 rubles);
• a fairly high probability of relapses and complications (about 11.2%);
• side effects in the form anal itching and burning at the site of excision of the fistula;
• inability to use for purulent fistulas.

Note! Laser excision of fistulous tracts is practiced in all private clinics in large cities, so there are usually no problems with finding a laser proctologist.

Radio wave therapy

More modern way removal of rectal fistulas is radio wave therapy. The method is suitable for the treatment of all types of fistulas, and its main advantage is the absence of the need to go to the hospital. The patient can go home within 10-20 minutes after the procedure, since it does not require general anesthesia: the doctor performs all actions under local anesthesia(traditionally Lidocaine or Ultracaine is used).

Complete healing and tissue repair after radio wave excision of the fistula occurs within 48 hours, so if the fistula was removed on Friday, the patient can return to work on Monday (the standard recovery period after surgical operation at least 14 days). To determine the most suitable treatment method for themselves, the patient can use the comparative characteristics given in the table below.

Table. Comparative characteristics various methods treatment of rectal fistulas.

Options	Laser treatment	Radio wave therapy	Surgical excision with a scalpel
Need for hospitalization	Usually not required (in some cases, the doctor may recommend observation for 1-2 days).	Not required. The patient can leave the clinic 20 minutes after the procedure.	Hospitalization of the patient to the hospital is required 2-3 days before the scheduled operation. After excision, the patient stays in the hospital for about 2-3 weeks.
Use of general anesthesia	Not required.	Not required.	Depending on the shape of the fistula and the degree of tissue damage, general anesthesia may be required.
Scars and scars after surgery	The probability is less than 5%.	The probability is less than 1%.	Over 92% chance.
Postoperative pain	None.	None.	They may disturb for several months, especially if the patient has a tendency to stool disorders.
Healing and recovery period	2 to 5 days.	48 hours.	Three weeks.
The likelihood of relapses and complications	About 11.2%.	Practically absent.	There may be complications.
Price	20-45 thousand rubles.	14000 rubles.	It is carried out free of charge under the compulsory medical insurance policy.

Important! Despite all the advantages of non-invasive methods of treating pararectal fistulas (without a scalpel), the doctor should make the final decision on the possibility of using these methods, based on the degree and severity of the lesion and general condition sick.

Treatment of rectal fistulas with folk methods

When choosing the most appropriate method of treatment, patients should understand that effective way treatment of anorectal and pararectal fistulas is only surgical therapy. Folk methods can be used as aid, which relieves inflammation, draws out pus and ensures the outflow of exudate. Some components effectively eliminate pain and accelerate tissue healing, but full recovery after applying even the most effective recipes is impossible. It's connected with anatomical features the structure of the fistulous passages, so the recipes below are recommended to be used only as adjuvant therapy after consultation with a doctor.

Honey ointment

Natural honey is one of the most effective anti-inflammatory agents. folk medicine. Honey and bee products (propolis, perga, royal jelly) contain more than 20 components that soothe the skin, relieve inflammation and stimulate tissue regeneration.

To prepare it, you need:

• 5 tablespoons of liquid honey mixed with 2 tablespoons of melted butter(use only natural oil, made from pasteurized cow's cream);
• add 15 drops of fir oil to the mixture;
• heat in a water bath to a boil and remove from heat;
• refrigerate for 8 hours.

With the resulting ointment, it is necessary to lubricate the affected area (you can use a swab) 5-6 times a day. Treatment should be continued for 3-4 weeks.

Herbal ointment with lard

Recipes based on lard are used for fistulas, accompanied by the formation of purulent exudate. Mixture medicinal herbs disinfects the skin, prevents ascending infection of the rectum and soothes inflamed tissues, accelerating healing and tissue repair. To prepare the ointment, you need:

• in a deep bowl, mix 1 teaspoon of oak bark, chamomile and water pepper herbs;
• add 300 ml of water and put on a slow fire for 20 minutes;
• cool the broth and strain, then add 4 tablespoons of melted lard to it;
• Mix everything and place in the refrigerator to set.

If the finished ointment is very liquid, you can add 1-2 tablespoons of butter to it, previously crushed with a fine grater, and then put the product back in the refrigerator. The ointment must be applied to a cotton swab and applied to the inflamed area. The tampon should be changed every 3-4 hours. good therapeutic effect can be achieved after 2-3 weeks of daily use.

Lotions with aloe juice and plantain

The juice squeezed from aloe leaves has a pronounced bactericidal and anti-inflammatory effect. Such lotions draw pus from the wound, provide its disinfection and reduce the intensity pain syndrome. Plantain has a stimulating and regenerating effect, so phytotherapists advise adding this component to traditional treatment aloe.

To squeeze the juice from aloe leaves, they must be thoroughly washed. cold water, crumple in hands and cut along the lateral line, then squeeze the pulp out of them. Plantain can be used as an infusion: pour 10 g of dried plantain root with a glass of boiling water and insist for 2 hours. Mix all ingredients and refrigerate for 1 hour.

A mixture of aloe juice and plantain infusion is used in the form of lotions: a cotton swab must be abundantly moistened with the agent and applied to the site of completion of the fistulous passage. Lotions need to be changed every 4 hours. Duration of use - 2 weeks.

Lotions with calendula

This is the easiest way to treat fistula at home. It will only require an alcohol tincture of calendula (you can buy it at a pharmacy for 30-50 rubles) and cotton pads or swabs. The swab should be moistened with plenty of tincture and applied to the fistula for 20-30 minutes. It is necessary to make 5-6 lotions per day. The duration of treatment depends on the tolerance of the components and the dynamics available. The recommended course of therapy is 7-10 days.

Note! Make lotions with alcohol tinctures necessary after hygienic washing. At the beginning of treatment, the patient may feel a strong burning sensation caused by the effect of ethanol on inflamed tissues. If such sensations do not disappear within 30 minutes after removing the tampon, the skin should be rinsed abundantly with cool running water and lubricated with a soothing ointment, for example, Bepanthen.

Olive oil and vodka ointment

This ointment helps to quickly relieve inflammation and has a positive effect on the condition of damaged tissues, stimulating their regeneration. In order for the ointment to have a thick consistency, it is necessary to purchase any fatty base in advance (glycerin, badger or goose fat, etc.). Mix 5 tablespoons of oil (it is better to use premium category oil) mixed with 50 ml of vodka and add 3 teaspoons of glycerin. If animal fat is used for cooking, the required thickness can be achieved using two tablespoons of fat.

All components should be thoroughly mixed and put in the refrigerator for several hours. It is necessary to apply the ointment up to 4-5 times a day, after use it is not necessary to wash it off. Significant improvements are usually observed already on the seventh day of treatment, but to achieve a stable result, it is recommended to use the remedy for at least two weeks.

Rectal fistula is an unpleasant, painful pathology that can lead to serious complications if not treated on time. the only effective method treatment of rectal fistulas today remains excision, which can be performed without surgery and the use of a scalpel. Home methods can be used as complementary therapy, but replace complete treatment They can not.

Video - Excision of the fistula of the rectum

Or a fistula (from the Latin fistula - tube) - a pathological channel connecting the focus of the disease (abscess, tumor) with the surface or some body cavity. Liquid secretions from the affected organ or tissue (urine, pus, intestinal, gastric contents or bile) constantly pass through them, so self-healing often becomes very difficult.

Fistulas can be congenital, acquired and artificial. Congenital are formed in connection with malformations. These include median and lateral fistulas of the neck, fistulas of the navel. Acquired fistulas result from purulent diseases- osteomyelitis, tuberculosis or trauma to organs and tissues. Sometimes fistulas, with therapeutic purpose are created artificially.

Types of fistulas

According to their location, fistulas can be internal or external, single or multiple.

Depending on the location, fistulas are purulent, urinary, gastric, salivary, bile, on the small and large intestines.

Purulent the fistula is located on the surface and is intended for the outflow of purulent discharge from the focus of the inflammatory process. In rare cases, the inflammation goes away on its own, then the suppuration stops and the fistula tightens, but then reopens.

Uric a fistula occurs on the ureters, bladder and urethra due to trauma, sometimes it is created artificially.

Gastric a fistula on the stomach is specially created artificially for enteral feeding.

on the small intestine occurs due to complications after surgical intervention or injury, with proper treatment, such a fistula heals quite quickly.

on the large intestine arises as a result of an injury, or it is created artificially, can heal on its own. When passing stool through the fistula, the skin is injured, so it is necessary to apply special ointments.

biliary fistula occurs as a complication after surgery, this fistula has bad consequences, so they need to be treated immediately.

Salivary fistula occurs as a result of inflammatory processes in the area of ​​\u200b\u200bthe area of ​​​​the cheeks, ear or neck, in this case saliva is released.

Causes

Inflammation of various nature (with the presence of a cavity with an infection), trauma with damage to the organ wall, chronic periodontitis, suppuration of the sutures.

Symptoms

weakness, fever, aching pain(can be very strong), discharge of pus with bad smell, itching, redness, swelling in the area in the fistula area.

Treatment with folk remedies

- Make candles from potatoes and when they dry a little, they must be held in a menovazine. And after the enema, insert them into the anus. Repeat the procedure every other day. A week later, potato candles should be processed already in the infusion of celandine and also put every other day. So alternate: a week with a candle with menovazine, a week with celandine (fistula in the large intestine).

— Tear off 12 leaves from the bottom of an aloe flower of 2-3 years of age, rinse well in boiled water, finely chop and pour into a liter jar. Pour aloe with fresh honey so that it completely covers it, close and put in a dark place for 8 days, shake well every day. Strain and take the infusion 1 hour spoon 3 times a day before meals. (Ligature fistula).

- Take mummy once a day on an empty stomach for 25-28 days (course of treatment). Dilute the mummy in 2-3 tablespoons of boiled water, and preferably in milk. With advanced disease, repeat the course after 10 days. The required amount of mummy intake per day depends on the person's weight: up to 70 kg. - 0.2g, 80kg - 0.3g, 90kg - 0.3-0.4g, over 90kg - 0.4-0.5g. And for the best result, at the same time as taking the mummy inside, apply the mummy and externally - rub the affected areas. To do this, dissolve 3 g of mummy in 100 ml of boiled water.

— Miracle ointment. Pour 1 cup of lean (sunflower) or olive oil, lower the natural wax (church candles will not work) the size of a matchbox. Put on a small fire to melt the wax. Take half of the yolk from a hard-boiled egg, grind it and send it in small pieces to the boiling mixture. The oil immediately begins to foam, so you need to be careful, quickly remove the pan from the heat - let it rage to the side, but at the same time you need to stir constantly. Put on the stove and send another piece of yolk to the brew, and so on, until the whole half of the yolk runs out. Then strain the mixture through a nylon cloth. Store the ointment in the refrigerator, warm it up a little before use. ( Purulent otitis media, all boils, fibroma, ulcer, gangrene, burns).

— All take 50g. Mix rosin, natural wax and honey, unsalted lard (melted lard), laundry soap and vegetable oil (sunflower). Grind all components and boil. When the mass cools down a little, add chopped onions, aloe and garlic. Put on the stove, let it boil and leave, wrapped, for 2 hours. Strain and lubricate sore spots, heat the ointment in a water bath before use. (Gangrene, abscesses, boils, fistulas, bitch udders).

— Take 1L vegetable oil, 30 ml of fresh juice of one whole stem and 100 ml of purified kerosene. Mix all components thoroughly and infuse in a dark, cool place for 7 days, shaking occasionally. Soak a sterile napkin with the resulting mixture and apply to the sore spot. Change the bandage 2 times a day for 2 weeks. Shake the mixture constantly before each use. (Gangrene, purulent wounds, ulcers, boils, fistulas, bough udders).

- Bring 2 liters to a boil, throw in the milk peeled 2 medium-sized onions and 4 cloves of garlic. Boil for 2 minutes, cool a little, and sit on it, wrapping a blanket around. Sit while the milk is hot. Such procedures are carried out daily until recovery. You can use the same milk each time.

- Take equal amounts of beeswax, mutton fat, spruce resin, honey and finely chopped garlic. Mix all the ingredients, put in a pan and, stirring constantly, melt over low heat. Sterile gauze soaked in this mixture is applied to the surface of a boil, abscess, fistula or festering wound. Such « plaster "quickly hardens, draws out pus well, cleans and disinfects wounds.

- Take 5 handfuls of sifted ash per 7 liters of water, boil for half an hour, stand and strain. Take a bath of warm lye for 20-30 minutes, you can simply wash the wound with this solution. Small filamentous worms, the culprits of the disease, should go into the water. Depending on the severity of the disease, this must be done several times, but sometimes 2-3 times are enough for the wound to clear, heal and the fistula no longer appears.

- Take 100g each - spruce resin, pork internal fat and beeswax. Mix, boil and cool. Apply a bandage with the resulting ointment to the treated wound. (Ulcers, burns, fistulas).

— Grate half a piece laundry soap and pass through a meat grinder 4 heads onion. Melt 50 g of unsalted butter in a saucepan over low heat, add onion to it and simmer for 10-15 minutes. Then add 300 g of interior lard, grated soap and constantly stir over low heat until a homogeneous mass is obtained. Put 2 church candles or 50g of pure wax and boil for another 5 minutes over low heat. Strain and put the mass in a clean sterilized dish and store in the refrigerator. Before use, the ointment can be warmed up. (Fistulas, purulent wounds).

A fistula is a channel formed in tissues or organs as a result of ulcerative processes. Fistulas are of two origins. Some appear as a result of operations whose purpose was to divert content certain body, and others as a result pathological processes occurring in the body.

Learning about what a fistula is and what are its causes, you need to familiarize yourself with the following positions:

• if a person encounters chronic periodontitis, fistulas can start from the roots of the tooth, passing through the gum and jaw;
• if there was a place in the body inflammatory process, then usually its effects heal for a long time. And if the inflammation has not yet been completely eliminated, rotting can begin in the depths of the tissues. As a result, a purulent fistula is formed;
• often the problem occurs with suppuration of postoperative sutures;
• in case of gunshot wounds, in the case when it was impossible to remove a bullet or a fragment, suppuration may appear nearby, which eventually becomes the cause of a fistula.

Symptoms

Different fistulas have their own symptoms that distinguish one type of problem from another. Signs of a fistula in the rectum are:

• a small opening near the anus through which pus is usually expelled. In this regard, patients have the need to wear a pad, as well as taking a shower several times a day;
• pain around the anus. As a rule, they have aching character. The strongest are at the time of defecation. They subside only after a certain time after that.

When we talk about bronchial fistulas, then by symptoms we usually mean specific endobronchitis, which gives out the appearance of fistulas. In the event that you have suffered a fistula that hit the gums, the symptoms are as follows:

• toothache, which begins to intensify when touched;
• the presence of purulent discharge that comes from the fistula channel;
• mobile teeth.

Diagnostic Measures

Diagnosis-related activities usually do not create any special difficulties. Complaints from patients, anamnesis of the disease, type of fistula, as well as the amount of pus that is released from it are taken into account.

According to doctors, research procedures help to clarify the diagnosis qualitatively, allowing to identify the level of hydrochloric acid. Such a diagnosis perfectly determines the presence or, conversely, the absence of fistulas in the stomach.

When we talk about urinary fistulas, they are betrayed by the characteristic presence of uric acid salts.

Treatment and preventive measures

Usually fistulas are subject to surgical intervention. Many of them are purulent, which were formed as a result of the operation, are eliminated by removing the ligatures. In this case, a clamp comes to the rescue, stopping the blood.

In addition to eliminating the focus of inflammation, you also need to get rid of the epithelial cover of the fistula. If the fistulas are congenital, then their doctors remove them exclusively with the help of surgical intervention, carrying out this procedure during the first days of the patient's life. Otherwise, the baby may simply die in the first days after its birth. At the same time, according to experts, purulent canals fistulas practically do not close.

Labiform fistulas are considered especially problematic in terms of treatment, since operations aimed at getting rid of them are radical. This is the suturing of the opening of the penis after the mobilization of its walls.

Prevention of those fistulas that are acquired and not congenital should include the prevention of infections. Required when solving a problem surgically strictly follow the rules of asepsis.

As for congenital fistulas, no preventive measures will help here, because the disease appears in the first three months of pregnancy.

If you know that you have encountered a fistula or have such suspicions, contact your doctor in time for help.