What causes bhagandar

What Causes Bhagandar (Anal Fistula)?

Bhagandar, medically termed an anal fistula, is a persistent, abnormal tract that forms between the inside of the anal canal and the skin surface surrounding the anus. This condition is often uncomfortable and can lead to various complications if left untreated. Understanding the underlying causes is crucial for prevention and effective management.

The Role of Anal Glands

The most common cause of bhagandar, accounting for an estimated 80-90% of cases, is the infection of the anal glands. These small glands are located within the anal canal and their primary function is to secrete mucus, which helps to lubricate the passage of stool. Normally, these glands drain freely into the anal canal. However, if one of these glands becomes blocked, stagnant secretions can accumulate, creating an environment ripe for bacterial growth and infection. This infection can lead to the formation of an abscess, which is a localized collection of pus.

Abscess Formation and Fistula Development

Once an anal abscess forms, the body's natural response is to try and drain the pus. In many cases, this drainage occurs spontaneously through the skin, forming an abnormal tunnel or tract. This tunnel, which connects the infected gland or abscess cavity to the exterior skin, is what we call an anal fistula or bhagandar. The opening on the skin is known as the external opening, and the internal opening is within the anal canal.

Contributing Factors and Other Causes

While infected anal glands are the primary culprit, several other factors and conditions can contribute to or directly cause bhagandar:

• Inflammatory Bowel Disease (IBD): Conditions such as Crohn's disease are strongly associated with the development of anal fistulas. In Crohn's disease, inflammation can affect any part of the digestive tract, including the anal canal, leading to abscesses and fistulas. It's estimated that between 20-40% of individuals with Crohn's disease will develop an anal fistula at some point.
• Infections: While less common than bacterial infections of the anal glands, other infections like tuberculosis (TB) can also cause anal fistulas. In regions where TB is prevalent, it's a more significant cause to consider. Sexually transmitted infections (STIs) can also, in rare instances, contribute to fistula formation.
• Diverticulitis: This condition, which involves inflammation of small pouches in the colon, can sometimes lead to a fistula forming between the colon and the rectum or anus.
• Trauma and Surgery: Previous surgery in the anal or rectal area, such as for hemorrhoids or anal fissures, can sometimes inadvertently damage the anal glands or create an entry point for infection, leading to fistula formation. Anal trauma, like that from childbirth or anal intercourse, can also increase the risk.
• Cancer: In rare instances, cancer of the anal canal or rectum can present as a fistula. This is a less common cause but is an important consideration, especially in older individuals or those with persistent, unusual symptoms.
• Radiation Therapy: Patients who have undergone radiation therapy to the pelvic region for cancer treatment may develop fistulas as a complication of the radiation damage to tissues.

Symptoms Associated with Bhagandar

The presence of a bhagandar is usually indicated by a range of uncomfortable symptoms, including:

• Persistent, throbbing pain around the anus, which may worsen when sitting, coughing, or during bowel movements.
• Swelling, redness, and tenderness in the area around the anus.
• A foul-smelling discharge from an opening on the skin near the anus. This discharge can be pus, blood, or stool.
• Irritation of the skin around the anus.
• Fever and chills if a significant infection or abscess is present.

Diagnosis and Treatment Considerations

Diagnosing bhagandar typically involves a physical examination by a healthcare professional, who will look for the external opening and inquire about symptoms. In some cases, further investigations like an MRI or CT scan may be necessary to map the extent and path of the fistula, especially if it is complex or suspected to be related to underlying conditions like Crohn's disease.

Treatment for bhagandar is almost always surgical, as fistulas rarely heal on their own. The goal of surgery is to drain the infected tract and allow it to heal. The specific surgical approach depends on the location and complexity of the fistula. Common procedures include fistulotomy (cutting open the tract), seton placement (using a thread to drain the tract over time), and advancement flap procedures.

Conclusion

In summary, bhagandar is most frequently caused by an infection in the anal glands that leads to abscess formation and the subsequent development of an abnormal tract. While less common, inflammatory bowel disease, infections, trauma, and other medical conditions can also be responsible. Prompt medical attention is essential for accurate diagnosis and appropriate treatment to relieve symptoms and prevent complications.