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Peripheral Vascular

Understanding Peripheral artery disease: Risk Factors, Complications and Prevention

Have you ever felt a strange pain in your legs while walking that eases up when you rest? This could be a sign of something more than just tired muscles. Peripheral artery disease (PAD) is a condition that many people have but are unaware of. This article explores the basics of peripheral artery disease, its risk factors, potential complications, and simple steps you can take to protect your arteries.

What is Peripheral artery disease?[1]

This is a condition where the arteries, which supply blood to the limbs, become narrowed or blocked. This happens due to a build-up of fatty deposits called plaque. When these arteries are narrowed, blood flow to the legs and other extremities is reduced, causing pain and other symptoms. The legs are the most commonly affected areas, leading to pain while walking, known as claudication.

Risk Factors for Peripheral artery disease[1]

a. Lifestyle Factors

  • Smoking: The chemicals in tobacco have the potential to damage the blood vessels. This makes it easier for plaque to build up and narrow the arteries.
  • Diet: A poor diet that is high in saturated fats, trans fats, and bad cholesterol can be one of the reasons behind the build-up of plaque in the arteries. Eating a healthy, balanced diet with plenty of fruits, vegetables, and whole grains might help to reduce the risk.
  • Physical Inactivity: Regular physical activity helps to maintain healthy blood flow and keeps the arteries well, helping them function and keeping disease at bay.

b. Health Conditions

  • Diabetes: High blood sugar levels might damage the blood vessels and contribute to plaque build-up.
  • Hypertension: High blood pressure puts extra strain on the arteries, which can lead to the damage and narrowing of these blood vessels.
  • High Cholesterol: Plaque formation can also occur due to elevated levels of cholesterol in the blood, increasing the risk of peripheral artery disease.

c. Demographic Factors[2]

  • Age: Older adults are more likely to develop this condition due to the natural hardening of the arteries over time.
  • Gender: Men are usually at a higher risk of developing peripheral artery disease than women. However, postmenopausal women also face a significant risk.
  • Family History: A family history of peripheral artery disease or other cardiovascular diseases can increase the likelihood of developing this condition.

Complications of Peripheral artery disease[2]

  • Critical Limb Ischemia: This is a severe condition where the blood flow to the limbs is significantly reduced, causing severe pain and potentially leading to sores or ulcers that takes time to heal.
  • Stroke and Heart Attack: There is an increased risk of stroke and heart attack as this condition affects the arteries supplying blood to the heart and brain.
  • Infections: Reduced blood flow can impair the healing of wounds and inadvertently increase the risk of infections.
  • Amputation: In severe cases, the lack of blood flow might lead to tissue death and the need for amputation of the affected limb.

Prevention of Peripheral artery disease[2]

a. Lifestyle Modifications

  • Quitting Smoking: Stopping smoking can significantly improve vascular health and reduce the risk of peripheral artery disease.
  • Healthy Diet: Eating a healthy, well-balanced diet like fruits, vegetables, and whole grains is necessary as it helps maintain healthy arteries and reduces the risk of plaque build-up.
  • Regular Exercise: Regular physical activity, such as walking, cycling, or swimming, improves circulation and overall vascular health.

b. Managing Health Conditions

  • Diabetes Management: Blood sugar levels should be kept under control to reduce the risk of peripheral artery disease in people with diabetes.
  • Blood Pressure Control: Maintaining healthy blood pressure through lifestyle modifications and, if necessary, medication helps protect the arteries from damage.
  • Cholesterol Management: Keeping cholesterol levels in check through diet, exercise, and medication can prevent plaque build-up in the arteries.

c. Regular Check-ups

  • Importance of Routine Health Screenings: Regular check-ups with a healthcare provider can help detect peripheral artery disease early and manage any risk factors effectively.
  • Discussing Symptoms Early: Reporting any symptoms, such as leg pain or numbness, to a healthcare professional can lead to early diagnosis and treatment.

Conclusion

Peripheral artery disease might sound intimidating, but understanding it is the first step towards taking control of your health. Don’t wait for symptoms to appear—start making healthier choices today. If you have any concerns, make sure to consult a healthcare professional and get regular check-ups.

[1] https://www.heart.org/en/health-topics/peripheral-artery-disease/about-peripheral-artery-disease-pad#:~:text=Peripheral%20artery%20disease%20is%20similar,to%20the%20legs%20and%20feet.
[2] https://www.hopkinsmedicine.org/health/conditions-and-diseases/peripheral-vascular-disease

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Piles

Role of Fibre in Preventing and Managing Piles

Are you tired of the discomfort and pain that comes with piles? You’re not alone. Many people struggle with this common condition, but there is a natural and effective way to find relief. Fibre, a humble nutrient found in everyday foods, plays a very important role in preventing and managing piles. In this blog, you will learn how adding more fibre to your diet can make a significant difference in your digestive health and overall well-being.

What is the Role of Fibre in Piles?[1]

Fibre adds bulk to the stool and helps it pass more easily through the intestines. There are two types of fibre: soluble and insoluble.

  • Soluble fibre dissolves in water and forms a gel-like substance, which slows down digestion.
  • Insoluble fibre does not dissolve in water and adds bulk to the stool, aiding in its movement through the digestive tract.

Sources of Dietary Fibre[2]

Incorporating fibre into your diet is simple and can be achieved through a variety of foods. Here are some excellent sources of dietary fibre:

  • Fruits: Apples, bananas, oranges, and berries.
  • Vegetables: Carrots, broccoli, spinach, and sweet potatoes.
  • Whole Grains: Brown rice, oatmeal, and whole wheat bread.
  • Legumes: Lentils, beans, and chickpeas.
  • Nuts and Seeds: Almonds, chia seeds, and flaxseeds.

Preventing Piles with Fibre[3]

  • Regular Bowel Movements: One of the primary benefits of fibre is its ability to promote regular bowel movements. Regular bowel movements prevent the build-up of pressure in the rectal veins, reducing the risk of developing piles. A fibre-rich diet ensures that your digestive system works efficiently, making it less likely for you to experience constipation, a major contributing factor to piles.
  • Softens Stool: Fibre helps soften the stool by absorbing water, making it easier to pass. Hard, dry stools can lead to straining during bowel movements, which can cause or worsen piles. By consuming enough fibre, you can maintain soft, easily passable stools, reducing the strain on your rectal veins.

Managing Piles with Fibre[3]

If you are already experiencing piles, making dietary adjustments to include more fibre can help manage the condition. A high-fibre diet can alleviate symptoms such as pain, itching, and bleeding. Here are some tips to increase your fibre intake:

  • Start your day with a high-fibre breakfast, such as oatmeal topped with fruits and nuts.
  • Include plenty of vegetables in your meals, aiming for a variety of colours and types.
  • Snack on fruits, nuts, and seeds instead of processed snacks.
  • Choose whole grains over refined grains.

Fibre Supplements

In addition to dietary changes, fibre supplements can be helpful in managing piles. Supplements can provide the necessary fibre intake if you are unable to get enough from your food alone. However, it is always recommended to consult your healthcare provider before consuming these supplements.

Recommended Fibre Intake for Piles

The recommended daily intake of fibre varies depending on age and gender. On average, adult women should aim for about 25 grams of fibre per day, while adult men should aim for about 38 grams[4]. These recommendations can serve as a guideline for adjusting your diet to ensure adequate fibre intake.

Sample High-Fibre Diet Plan[5]

To help you add more fibre into your diet, here’s a sample high-fibre diet plan:

Breakfast:

  • Oatmeal cooked with milk, topped with chopped apples, almonds, and a sprinkle of chia seeds.
  • A glass of freshly squeezed orange juice.

Mid-Morning Snack:

  • A bowl of mixed fruits such as papaya, guava, and pomegranate.

Lunch:

  • Brown rice or whole wheat roti.
  • A serving of dal (lentil soup) and a vegetable curry made with spinach, carrots, and peas.
  • A side salad with cucumbers, tomatoes, and a lemon dressing.

Afternoon Snack:

  • A handful of roasted chickpeas or a small bowl of yoghurt with flaxseeds.

Dinner:

  • Quinoa or whole wheat pulao.
  • A serving of mixed vegetable curry with beans, cauliflower, and sweet potatoes.
  • A side of sautéed greens such as spinach or methi (fenugreek leaves).

Before Bed:

  • A small bowl of fruit salad or a few pieces of dried figs.

Conclusion

Incorporating more fibre into your diet is a natural and effective way to prevent and manage piles. Start making these changes today to experience the benefits of a healthier, more comfortable life.

Reference Links:

[1] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983#:~:text=Soluble%20fiber.,%2C%20carrots%2C%20barley%20and%20psyllium.
[3] https://www.news-medical.net/health/Prevention-of-piles-(Haemorrhoids).aspx
[4] https://www.medicinenet.com/how_can_i_eat_25_grams_of_fiber_a_day/article.htm#:~:text=According%20to%20the%20American%20Heart,may%20need%2030%2D38%20grams.
[5] https://www.healthifyme.com/blog/high-fibre-diet/
https://www.lybrate.com/topic/high-fiber-diet
https://www.prevention.com/food-nutrition/a20516445/high-fiber-diet-plan/
https://www.medicalnewstoday.com/articles/hemorrhoids-high-fiber-diet#foods-to-eat
https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/eating-diet-nutrition
https://www.guysandstthomas.nhs.uk/health-information/piles-haemorrhoids/lifestyle-changes#:~:text=Eat%20a%20high%20fibre%20diet&text=Eating%20lots%20of%20high%2Dfibre,muesli%2C%20oats%20and%20bran%20flakes

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Sinusitis

Differentiating Between Headaches and Sinus Headaches

Introduction

Many of you must have experienced that typical sensation triggering a varied range of pain in the parts of your head. The pain creates inconvenience, stress, and discomfort, hampers the routine, and makes daily activities challenging. This pain in the head and face area is termed a headache. The pain may be in different parts of the head with varying duration and symptoms. Headaches are common, and some people are more prone than others. However, its frequency and associated symptoms must be monitored to prevent them from worsening to severe health conditions. 

Headaches may result from environmental changes or routine changes, like exposure to excessive noise, heat, or fast observation. Sometimes, they may be the symptom of underlying disease, as in the case of sinusitis. The cause of headaches could be different. The difference in the type of headaches must be understood to treat it effectively and timely. 

The present blog discusses sinus headaches, how they are different from other headaches and their treatment options to enable readers to make informed decisions about treating specific types of headaches effectively.

Types of Headache

The throbbing pain of headaches is known to many; its severity, symptoms, and treatment may differ depending on its type. The different types of headaches are –

  • Migraine headache is a reoccurring headache with pain on one side. It often comes with blurry vision, heightened sensitivity to light and sound, or nausea and vomiting.
  • Tension headaches are often caused by stress, tension, and anxiety with symptoms of pain, tenderness in the head, face, and neck, and sensitivity to light and/or sound.
  • Cluster headache is a severe and recurring headache, with symptoms of watery eyes, blocked nose, and swelling eyelids.
  • Hormone headache is also known as menstrual headache and is caused in women due to hormonal changes.
  • Sinus headache is caused by an infection in the sinuses.
  • Hypnic headache usually occurs in old age with no specific cause identified.
  • Rebound headache is a secondary type of headache caused by overuse of medications. It may subside with medication but reoccurs.

What is a sinus headache?

A sinus headache is caused when the sinuses get inflamed and blocked due to infection and cannot drain the mucus from the nasal passage. The resultant pressure in the sinuses causes pain in the head. A sinus is a space inside the forehead, cheeks, and behind the nose. The space is filled with air, which helps drain the mucus, keeping the nasal passage clear from bacteria and other types of infection. The condition of infection and inflammation in the tissue lining of the sinuses is known as sinusitis. Sinusitis is caused by viruses, bacteria, allergens, or fungi infection. 

How is sinus headache different from other types of headaches?

Headaches due to sinuses are often mistaken for other types of headaches like migraine, tension headaches, and hypnic headaches, to name a few. However, the cause, symptoms, severity, and duration of the headache help determine the type of headache.

  • Sinus headaches and migraines are often confused due to shared symptoms like watery eyes, pressure on the face, congestion, pain while bending forward, or runny nose. Migraine causes pain on one side of the temple, eyes, and back of the forehead. It is associated with sensitivity to loud noise, bright lights, nausea, and vomiting. The pain lasts for hours or a day or two.
  • Similarly, tension headaches caused by stress, fatigue, anxiety, and exposure to sound last for a few hours. The pain is felt in the entire head and is mild or moderate. It affects the back of the head, the neck, and both sides.
  • The rebound headache caused by overuse of medications is often accompanied by nausea, vomiting, restlessness, loss of memory, and irritability. Pain-relieving medications help relieve the pain for the time being, and the headache rebounds when its effect is gone. The overuse of pain relievers triggers headaches.
  • On the other hand, a sinus headache caused by infection is followed by fever. It causes thick discoloration of mucus discharge, cough, pain in the cheeks and teeth, or loss or decrease in sense of smell. It lasts for days or weeks, depending on the type of sinusitis.

How to treat a sinus headache?

The treatment options for each type of headache are different and unique. One must avoid trying to treat one type of headache with the treatment option of the other and prevent its worsening.

Sinus headaches must be treated with an effective diagnosis of the underlying causes and symptoms through allergy tests, X-rays or CT scans. Risk factors like allergies, colds, exposure to smoking, weakened immune system, and structural nasal deformity need to be understood and addressed. The treatment starts with home remedies to relieve the pain, which include nasal sprays, steam inhalation or use of vaporizers, and the application of warm compressors to relieve swelling or pain in the affected areas. 

Generally, sinuses go on their own or with the help of medications. Still, in cases of severe and long-lasting symptoms of sinusitis, the doctor may recommend sinus surgery.

  • FESS– Functional Endoscopic Sinus Surgery- FESS is a simple and standard surgical treatment option for unhealthy sinuses. The surgery involves widening the nasal passages between the nose and the sinuses to remove the infected bone or tissues obstructing the drainage of the mucus. 
  • Balloon Sinus Ostial Dilation- Balloon sinuplasty drains the mucus and relieves the patient of sinus symptoms using a balloon placed at the tip of the flexible catheter. When the catheter reaches the correct position, the balloon is inflated to open and widen the sinus cavities, and the mucus gets flushed out. The procedure does not require incisions as it is done through the nostrils.
  • Turbinate Reduction- During turbinate (a small bony structure inside the nose) surgery, the surgeon reduces the turbinate size with a needle-like instrument inserted inside the nose. 

Conclusion

Sinus headaches are signs of sinus infection. They differ from other types of headaches regarding their causes, symptoms, severity, and duration. These headaches could be challenging and affect the patient’s quality of life. Most cases, the symptoms may go away with home remedies or medications. Still, in severe cases, surgical intervention might be needed. Never take frequent headaches lightly, for they may develop into worsening conditions. Timely medical attention and assessment are necessary for effectively treating sinus headaches.

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Hernia

Understanding Postpartum Hernia: A Comprehensive Guide

Introduction

Motherhood is the most sacred feeling of every woman who brings and nurtures a new life with unconditional love. Women undergo transformative changes, not just emotionally or psychologically but physically as well, during and after pregnancy. Giving birth to a new life is a blessed moment for every woman and her near and dear ones. Still, one must not overlook the health concerns and complications often faced and experienced by them. These health issues could range from high blood pressure, gestational diabetes, excessive bleeding, anemia, and infection, including conditions like postpartum bodily changes, emotional stress and depression, fatigue, anxiety, or hernia.

Understanding the postpartum emotional, physical, and psychological health of women during and after pregnancy is of paramount importance for addressing the underlying causes and treating the symptoms of any such complications timely and adequate.

This blog discusses one such postpartum medical condition, hernia, along with its types, symptoms, and treatment for general awareness and information.

What is Postpartum Hernia?

The term ‘postpartum’ refers to the medical condition of a woman after childbirth. Postpartum hernia is when the abdomen muscles get stretched due to weight gain, and a growing baby increases pressure on the abdominal wall. The belly fat, or the abdomen’s interior, pushes against the weak muscles, or the belly button protrudes through the weak muscles. In short, any hernia post-delivery is known as a postpartum hernia.

Causes of Postpartum Hernia

Physical changes that result in weight gain or obesity, excessive pressure or fluid buildup in the abdomen, multiple pregnancies, the birth of twins or triplets, heavy coughing, and c-section surgery are some of the common causes of postpartum hernia.

Types of Postpartum Hernia

Hernia, post-delivery, could be of various types. These types include-

  • Umbilical hernia- The fetus is connected to the mother in the womb through an umbilical cord. This cord passes through the opening in the baby’s abdomen, which generally closes after birth. However, when this umbilical cord does not close completely, it leaves a weak spot in the baby’s abdomen, which may lead to a hernia anytime in the future. These hernias are commonly seen in infants but are also seen in women when the spot where the umbilical cord detached at birth does not heal.
  • Inguinal hernia- During pregnancy, there can be pressure near the groin. Inguinal hernia occurs when the abdomen or intestine tissue bulges out through the opening in the lower abdominal wall. Inguinal hernia is caused in the inguinal canal.
  • Ventral hernia- Ventral hernia occurs above the belly button, in the middle of the stomach. Also known as incisional hernia, it occurs at the previous surgical incision site, as in the case of c-section surgery that is not healed. The tissue protrudes from the weakened part of the abdominal wall, resulting in a bulge.

Symptoms of postpartum hernia

Hernias cause pain and discomfort. Though not a severe medical condition, it must be treated properly to prevent its severity. Some of the common symptoms of postpartum hernia are-

  • Pain in the abdomen
  • Bulge in the abdominal area or near the c-section site
  • Vomiting or constipation due to strangulation of hernia
  • Tenderness in the abdominal area
  • Heightened pain and bulge due to pressure, coughing, lifting, or any physical activity

Treatment for postpartum hernia

In cases of small or minor hernia with no discomfort or pain, there is no need for urgency for its treatment. One may wait for it to grow in size to be treated surgically or laparoscopically. In cases of severe discomfort and pain, hernia needs to be treated timely and properly. However, one may avoid postpartum hernia by observing specific precautionary measures of avoiding heavy lifting, rigorous exercise, or physical exertion, ensuring support to the abdomen in case of severe coughing or sneezing to reduce pressure. Postpartum workout for strengthening the core muscles also helps in preventing hernia occurrence. It may be noted that postpartum hernia is treated through open hernia surgery or laparoscopic procedure.

  • Open surgery- In the case of open surgery, the surgeon cuts open the abdomen with a large incision to access the hernia site, pushes the hernia back to place, and closes the incision with stitches.
  • Laparoscopic procedure- Also known as a keyhole procedure, the hernia is placed back into its position using tiny instruments inserted through smaller incisions on the abdomen. Once put in place, it is supported by a mesh attached to the surrounding tissues, thus reducing the chance of hernia reoccurrence. Hernia treatment involves pushing the protrusion back to its place and supporting it by placing a mesh.

The doctor often recommends using an abdominal binder (a wide belt worn around the abdomen) to support the treated hernia.
Recovery from hernia treatment requires nearly a few weeks of rest from physical activities that exert pressure on the abdomen.

Conclusion

Though hernias are not severe, they often become painful and cause discomfort if not treated promptly. Postpartum hernia can be prevented through adequate rest and avoiding activities that would exert pressure on the abdomen. The likelihood of hernia occurrence is high if one becomes pregnant again. Resorting to non-surgical techniques of workouts to strengthen the core muscles may help in preventing postpartum hernia. However, in cases of large and painful hernia symptoms, hernia repair is the only effective treatment option.

References

https://medlineplus.gov/ency/article/000987.html
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Piles

Anal Fistula: Symptoms, Causes, Diagnosis, Treatment

Introduction

When two body cavities or a body cavity and skin connect abnormally, they form a fistula. A fistula can be formed in many parts of the body, namely between the cervix and vagina, the neck and the throat, an artery, and a vein, the bowel and vagina, stomach and skin surface, anus and skin surface, skull space, and nasal sinus. These fistulas could be open (one end open), complete (both ends open), incomplete (closed inside), or horseshoe (connecting the anus to the skin surface). Some fistulas may heal on their own, while some may not. The treatment depends on the type, location, cause, and severity of the condition.

An anal fistula is one such types of fistula that most commonly affect men. Following an infected anal gland that does not heal, it needs surgical treatment for its cure.

The present blog provides insight into the meaning, causes, symptoms, diagnosis, and treatment of anal fistula for a better understanding of the condition.

What is an Anal Fistula?

An anal fistula, also known as a Fistula-in-Ano, is an abnormal connection between the surface of the skin of the bullock and the anal canal in the colon. It is a tunnel running from inside the anus to the skin surface around it. An anus is an opening at the end of the digestive tract that gets rid of the solid waste of the body. Anal fistula affects the internal and/or external anal sphincters (muscles).

What Causes Anal Fistula?

An infection in the anal gland is the primary cause of anal fistula. This infection causes an abscess. An abscess is a tender mass over skin filled with pus and bacteria, painful and warm to feel.

The other cause of anal fistula includes –

  • an injury or surgery in the anus,
  • radiation therapy in the pelvic region,
  • tuberculosis (infection in the lungs),
  • Crohn’s disease (inflammation of the digestive tract),
  • ulcerative colitis (inflammation of the large intestine) or
  • sexually transmitted diseases.

Symptoms of Anal Fistula?

Anal fistula symptoms require immediate medical consultation and intervention for its treatment. Some of the symptoms of anal fistula are-

  • Fever
  • Swelling and redness around the anus,
  • Pain during bowel movement or urination
  • Fowl smelling pus or watery discharge from the abscess
  • Bleeding

How is Anal Fistula Diagnosed?

The diagnosis of anal fistula starts with medical history and physical examination of the patient. Some fistulas can be easily spotted, and the doctor may examine through the oozing blood fluid.

For those that are closed, the doctor may need to find the inside source of the fistula. For this, they may use an anoscope or a proctoscope to examine the anal canal. The patient is put on anesthesia during the examination. 

The use of special dye to find the internal source of the anal fistula is also resorted to by the doctor. For this, the doctor injects a special dye that would react with the infection, creating bubbles at the injection site.

Ultrasound and MRI are some of the imaging studies that the healthcare provider may conduct for the diagnosis of anal fistula.

Treating Anal Fistula

The treatment for anal fistula depends on the severity of the condition and the type of fistula. Before arriving at the decision for anal fistula surgery, the healthcare provider may try to treat it with medications. However, spontaneous healing may cause the fistulas to reopen if there is infection again. The treatment varies depending on whether the fistula is simple or complex. Simple fistula has less muscle involved that needs to be treated. Complex fistula treatment requires addressing more muscle damage. The treatment options for fistula are-

  • Fistulotomy– Fistulotomy is the most common one-time surgery for simple fistulas. The surgeon cuts through the fistula, opens the infected area, and removes the damaged muscle.
  • Seton drain– For complex fistulas, the surgeon uses a surgical thread called the seton that keeps the fistula open and helps drain the infection. The seton is passed from the opening of the fistula through its track out to the anus with a loop at the end. It acts as a wick to drain the infection and heal the fistulas. Later, it may be closed with a fistulotomy. A seton is generally required to be removed; however, in some cases, it might be placed for an indefinite time.
  • Endorectal advancement flap– The infection is accessed through the inside opening of the fistula and cut out. The opening is then covered with healthy tissue from the inside of the rectum above it. This flap of the healthy tissue is pulled down from the rectum to fill the opening. The infection drains out from the outside of the fistula opening. In some cases, there are chances of reoccurrence of infection and fistula, along with the risk of damaging the muscles.
  • LIFT- The procedure is known as the Ligation of the Intersphinteric Fistula Tract. It avoids cutting the sphincter muscles. The surgeon accesses the fistula between the internal and external muscles through an incision at the anal track opening and treats the infection, and then closes the incision with stitches.

Conclusion

Fistulas are not life-threatening; however, they may become life-challenging, affecting the patient’s quality of life. Anal fistulas usually need to be treated surgically depending on the severity and location of the fistula. A timely address requires an informed decision based on the risk assessment and successful surgical outcomes of the various treatment options. Living with a fistula is challenging, and its treatment varies depending on its severity and complexity. Immediate and timely medical intervention is the only way to treat it, enabling quality and healthy living.

References

https://my.clevelandclinic.org/health/diseases/14466-anal-fistula
https://www.mayoclinic.org/diseases-conditions/anal-fistula/symptoms-causes/syc-20352871
https://www.webmd.com/digestive-disorders/anal-fistula-overview
https://www.hopkinsmedicine.org/health/conditions-and-diseases/anal-fistula
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/fistula

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