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symptomes and Management of perianal Fistula 
Perianal Fistula is considered as a communication between the anal canal and the skin with abnormal tract that can got infected and cause various symptomes like perianal pain, tenderness, fever, pus discharge and erythema. Perianal Fistula are divided in to tow type: Low perianal fistula that is not involving anal external sphincter and high perianal fistula invloving the external sphincter. Depending on the Type of fistula the management of the fistula is planned. The main proplem of the perianal fistula is recurrence and continious discharge of purulent discharge even without tenderness or fever. to get a radical soloution of the fistula the tract should be closed by surgical excsion in case of low fistula and seaton placement in case of high perianal fistula. its also recommended to use Fusidic acid cream on the wound in addition to sits paths of warm water to help clean the tract. A consultation of your treating surgeon to decide the surgical option.
Required Investigations 
After proper physical exam, CBC should be done to discover any increase in WBC as indicator of infection, Secretion culture and sensitvity should be done to detect the proper Antibiotic to use, Stool analysis for Calprotectin a substance that is specific for Crohns disease ( Common cause of Perianal fistula associated with attacks of diarrhea ) in addition to colonoscope to detect any signs of Crohns disease.  Pelvic MRI should be done to detect fistula type.
Causes 

• Recurrent perianal Abscess 
• HIV
• Crohns disease 

Our Advice 
You are adviced to have a balanced diet rich in vegetables and fresh fruits, avoid smoking and perform daily regular exercise.