title: Quality of life with anal fistula.
abstract: BACKGROUND
  Anal fistula affects people of working age. Symptoms include abscess, pain, discharge of pus and blood. Treatment of this benign disease can affect faecal continence, which may, in turn, impair quality of life (QOL). We assessed the QOL of patients with cryptoglandular anal fistula.
  
  
  METHODS
  Newly referred patients with anal fistula completed the St Mark's Incontinence Score, which ranges from 0 (perfect continence) to 24 (totally incontinent), and Short form 36 (SF-36) questionnaire at two institutions with an interest in anal fistula. The data were examined to identify factors affecting QOL.
  
  
  RESULTS
  Data were available for 146 patients (47 women), with a median age of 44 years (range 18-82 years) and a median continence score of 0 (range 0-23). Versus population norms, patients had an overall reduction in QOL. While those with recurrent disease had no difference on continence scores, QOL was worse on two of eight SF-36 domains (p<0.05). Patients with secondary extensions had reduced QOL in two domains (p<0.05), while urgency was associated with reduced QOL on five domains (p<0.05). Patients with loose seton had the same QOL as those without seton. No difference in urgency was found between patients with and without loose seton. In primary fistula patients, 19.4% of patients experienced urgency versus 36.3% of those with recurrent fistulas.
  
  
  CONCLUSIONS
  Patients with anal fistula had a reduced QOL, which was worse in those with recurrent disease, secondary extensions and urgency. Loose seton had no impact on QOL.
authors.affiliation: St Mark's Hospital , UK.
authors.forename: H A
authors.initials: HA
authors.lastname: Owen
authors.affiliation: Imperial College Healthcare NHS Trust , UK.
authors.forename: G N
authors.initials: GN
authors.lastname: Buchanan
authors.affiliation: Guy's and St Thomas' Hospital , UK.
authors.forename: A
authors.initials: A
authors.lastname: Schizas
authors.affiliation: University College London Hospital , UK.
authors.forename: R
authors.initials: R
authors.lastname: Cohen
authors.affiliation: Guy's and St Thomas' Hospital , UK.
authors.forename: A B
authors.initials: AB
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005242:Fecal Incontinence; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012003:Rectal Fistula / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Abscess; Quality of life; Rectal fistula