Rectovaginal fistula

Overview

A rectovaginal fistula is a condition where a connection forms between the lower part of the large intestine (rectum or anus) and the vagina. This abnormal connection allows bowel contents to leak through, causing gas or stool to pass through the vagina. A rectovaginal fistula can cause significant physical and emotional distress, impacting daily life and relationships.

Types of Rectovaginal fistula

Rectovaginal fistulas can be classified into two main types:

1. Primary rectovaginal fistula: This type of fistula occurs when there is a congenital defect in the formation of the pelvic floor or anal canal.
2. Secondary rectovaginal fistula: This type of fistula occurs as a result of an injury or trauma, such as during childbirth, surgery, or radiation therapy.

Causes of Rectovaginal fistula

A rectovaginal fistula can occur due to various factors, including:

1. Injury during childbirth: Trauma during childbirth can cause damage to the pelvic floor muscles and tissues, leading to the formation of a fistula.
2. Crohn's disease or other inflammatory bowel disease: Chronic inflammation and scarring can lead to the formation of a fistula.
3. Radiation treatment or cancer in the pelvic area: Radiation therapy or cancer can cause damage to the tissues and muscles in the pelvic area, leading to the formation of a fistula.
4. Complication after surgery in the pelvic area: Surgery in the pelvic area can lead to complications, such as a rectovaginal fistula.
5. Complication from diverticulitis: Infection of small bulging pouches in the digestive tract can lead to complications, such as a rectovaginal fistula.

Risk Factors of Rectovaginal fistula

The following risk factors may increase the likelihood of developing a rectovaginal fistula:

1. Age: Women over 40 years old are more likely to develop a rectovaginal fistula.
2. Childbirth: Women who have experienced childbirth are more likely to develop a rectovaginal fistula.
3. Crohn's disease or other inflammatory bowel disease: People with chronic inflammatory bowel disease are more likely to develop a rectovaginal fistula.
4. Radiation therapy: People who have received radiation therapy in the pelvic area are more likely to develop a rectovaginal fistula.

Symptoms of Rectovaginal fistula

Preventions of Rectovaginal fistula

Prevention is key in managing rectovaginal fistulas. The following measures can help reduce the risk of developing a rectovaginal fistula:

1. Proper care during childbirth: Proper care during childbirth can help reduce the risk of developing a rectovaginal fistula.
2. Proper management of chronic inflammatory bowel disease: Proper management of chronic inflammatory bowel disease can help reduce the risk of developing a rectovaginal fistula.
3. Avoiding excessive straining during bowel movements: Excessive straining during bowel movements can increase the risk of developing a rectovaginal fistula.
4. Maintaining a healthy diet: A healthy diet rich in fiber can help reduce the risk of developing a rectovaginal fistula.

Diagnosis of Rectovaginal fistula

Diagnosis of a rectovaginal fistula typically involves:

1. Physical examination: A physical examination is performed to assess the severity of the condition and identify any signs of infection or inflammation.
2. Endoscopy: Endoscopy may be performed to visualize the rectum and vagina and identify any abnormalities.
3. Imaging studies: Imaging studies such as CT or MRI scans may be performed to confirm the diagnosis and identify any underlying conditions.
4. Anorectal manometry: Anorectal manometry may be performed to assess the function of the anal sphincter and rectum.

Treatment for Rectovaginal fistula

Treatment and Management: Treatment for a rectovaginal fistula typically involves a combination of medications, lifestyle changes, and surgery.

Medications: Medications may be used to manage symptoms such as pain, discomfort, and infection.

1. Pain relievers: Pain relievers such as acetaminophen or ibuprofen may be prescribed to manage pain and discomfort.
2. Antibiotics: Antibiotics may be prescribed to treat infections and prevent further complications.
3. Steroids: Steroids may be prescribed to reduce inflammation and swelling.

Lifestyle Changes: Lifestyle changes can help reduce symptoms and improve quality of life.

1. Dietary changes: Eating a high-fiber diet can help reduce symptoms and improve bowel function.
2. Exercise: Regular exercise can help strengthen the muscles in the pelvic floor and improve bowel function.
3. Avoiding straining: Avoiding straining during bowel movements can help reduce symptoms and improve bowel function.

Surgery: Surgery may be necessary in some cases to repair the fistula and restore normal bowel function.

When to See a Doctor: If you are experiencing symptoms of a rectovaginal fistula, it is essential to see a doctor promptly. Delaying treatment can lead to further complications and affect quality of life.

Relevant Medical Specialists: The following medical specialists may be involved in the diagnosis and treatment of rectovaginal fistulas:

1. Gastroenterologists: Gastroenterologists are specialists in the diagnosis and treatment of digestive disorders.
2. Colorectal surgeons: Colorectal surgeons are specialists in the diagnosis and treatment of conditions affecting the colon and rectum.
3. Obstetricians and gynecologists: Obstetricians and gynecologists are specialists in the diagnosis and treatment of conditions affecting women's reproductive health.

When to seek medical attention ?

If you are experiencing symptoms of a rectovaginal fistula, it is essential to see a doctor promptly. Delaying treatment can lead to further complications and affect your quality of life.

Here are some signs that you should see a doctor:

1. Prolonged bleeding: If you experience prolonged bleeding or spotting after bowel movements, it could be a sign of a rectovaginal fistula.
2. Foul odor: If you notice a foul odor from your vagina, it could be a sign of a rectovaginal fistula.
3. Discomfort or pain: If you experience discomfort or pain during bowel movements, it could be a sign of a rectovaginal fistula.
4. Gas or stool passing through the vagina: If you notice gas or stool passing through the vagina, it could be a sign of a rectovaginal fistula.
5. Increased frequency of bowel movements: If you experience an increase in frequency of bowel movements, it could be a sign of a rectovaginal fistula.
6. Changes in bowel habits: If you experience changes in your bowel habits, such as loose stools or diarrhea, it could be a sign of a rectovaginal fistula.
7. Abdominal pain: If you experience abdominal pain, it could be a sign of a rectovaginal fistula.
8. Fever: If you experience fever, it could be a sign of an infection related to the rectovaginal fistula.
9. Vaginal discharge: If you experience vaginal discharge, it could be a sign of an infection related to the rectovaginal fistula.

If you are experiencing any of these symptoms, it is essential to see a doctor promptly. Delaying treatment can lead to further complications and affect your quality of life.