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Наружное отверстие свища обычно расположено на коже промежности, рядом с анусом [7](https://gemotest.ru/info/spravochnik/zabolevaniya/svishch-pryamoy-kishki/). \n\nСвищи могут быть простыми (один прямой ход без дополнительных ответвлений) и сложными (ход извилистый, с множественными ответвлениями, рубцами или гнойными полостями) [6](https://locmr.ru/articles/svishch-pryamoy-kishki/).\n\n\n\n## Причины\nОсновная причина — **острый парапроктит** — воспаление тканей, окружающих прямую кишку [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/)[7](https://gemotest.ru/info/spravochnik/zabolevaniya/svishch-pryamoy-kishki/)[10](https://volgograd.sovamed.ru/zabolevaniya/pararektalnyy-svishch/). Другие возможные причины: \n* травмы анального канала и последствия операций [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/); \n* воспалительные заболевания кишечника, например, болезнь Крона или язвенный колит [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/)[6](https://locmr.ru/articles/svishch-pryamoy-kishki/); \n* злокачественные опухоли прямой кишки [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/); \n* осложнения после родов или проктологических процедур [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/); \n* хронические запоры и анальные трещины [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/).\n\n## Симптомы\nНекоторые симптомы свища прямой кишки: \n* **Выделения из отверстия на коже** — гнойные, слизистые или кровянистые [11](https://proctocentr.ru/lechenie-svishhej/pryamoj-kishki). \n* **Боль и дискомфорт** в области свища, особенно при дефекации, длительном сидении или ходьбе [11](https://proctocentr.ru/lechenie-svishhej/pryamoj-kishki). \n* **Раздражение и зуд** кожи вокруг свища [11](https://proctocentr.ru/lechenie-svishhej/pryamoj-kishki). \n* **Отёк и воспаление** вокруг свища [11](https://proctocentr.ru/lechenie-svishhej/pryamoj-kishki). \n* **Общее недомогание** в периоды обострения воспаления — слабость, повышение температуры тела и озноб [11](https://proctocentr.ru/lechenie-svishhej/pryamoj-kishki). \n* **Неприятный запах** хронических гнойных выделений из свища [11](https://proctocentr.ru/lechenie-svishhej/pryamoj-kishki). \n* **Недержание кишечного содержимого** в тяжёлых случаях, когда свищ поражает анальный сфинктер [11](https://proctocentr.ru/lechenie-svishhej/pryamoj-kishki).\n\n## Диагностика\nПри подозрении на свищ прямой кишки необходимо обратиться к проктологу (колопроктологу) или к хирургу [7](https://gemotest.ru/info/spravochnik/zabolevaniya/svishch-pryamoy-kishki/). Для диагностики могут назначить: \n* **Пальцевое исследование** — врач определяет расположение внутреннего отверстия свища [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). \n* **Фистулографию** — визуализацию свищевых ходов с применением контрастного вещества [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). \n* **Ректороманоскопию** — метод помогает выявить сопутствующие заболевания прямой кишки, а также уточнить локализацию внутреннего отверстия [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). \n* **МРТ или УЗИ с ректальным датчиком** — эти исследования врач может назначить в некоторых случаях для более точной визуализации свища [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/).\n\n## Лечение\n**Основной метод лечения — хирургическое вмешательство** [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/)[8](https://cmrt.ru/zabolevaniya/zabolevaniya-vnutrennikh-organov/svishch-zadnego-prokhoda/). Цель операции — удалить свищевой ход, устранить источник инфекции и сохранить функцию анального сфинктера [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). Некоторые варианты хирургического лечения: \n* **Рассечение свища с последующим дренированием** — хирург рассекает свищевой ход по всей его длине, открывая канал [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). После рассечения устанавливают дренаж, чтобы предотвратить скопление гноя [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). \n* **Установка лигатуры** — метод применяется при сложных и глубоких свищах [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). Лигатура — специальная медицинская нить, которую проводят через свищевой канал [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). Постепенно, в течение нескольких недель или месяцев, лигатура затягивается, обеспечивая постепенное иссечение тканей свища [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). \n* **Лазерная абляция** — малоинвазивный метод лечения свищей [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/). Специальный зонд вводят в место формирования свища, зонд нагревает ткани, разрушает ткани свища и закрывает полость [1](https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/).","linksData":[{"sourceId":1,"url":"https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/","shownUrl":"https://gutaclinic.ru/articles/svishchi-pryamoy-kishki/","title":"Свищи прямой кишки: диагностика и современные методы лечения","shortUrl":"gutaclinic.ru","isTranslated":false,"description":"","greenUrl":"gutaclinic.ru"},{"sourceId":2,"url":"https://www.mediccity.ru/directions/179","shownUrl":"https://www.mediccity.ru/directions/179","title":"Параректальные свищи (свищи прямой кишки). 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