iHeart Radio Interview: New Hope for Anal Fistula Patients

Today we’re talking about a painful and often misunderstood medical condition that affects thousands of people every year, anal fistula, and the emotional and physical toll it can take on patients and families is tremendous.

So joining us right now is Dr. Dr. Philip Pearson, a colorectal surgeon, an educator known online as the singing surgeon, to discuss how this condition impacts quality of life and how many patients struggle in silence and how a new minimally invasive treatment called BioHealx is offering hope for healing with fewer complications and faster recovery.

We’ll also talk about Dr. Pearson’s use of music and social media to educate the public and make difficult health conversations a lot more approachable.

Well, Dr. Pearson, thank you so much for joining us. To begin, what exactly is an anal fistula and how does this condition develop?

So, an anal fistula is a little tunnel that begins in an infected anal gland. There’s about 15 to 20 glands that line the anus about an inch inside. Nobody really knows they’re there until, of course, you get one of these problems, but we all have them. There’s no problem with having them. And one of those little glands can get spontaneously infected and that begins the infection.

The infection then pushes outside the anus, can cause a really bad abscess and over time can develop into what is called a fistula. And a fistula just basically means a tunnel between one thing and another.

Well, we understand this this condition often affects younger adults, which I think is kind of fascinating, especially men between 18 and 50. What symptoms should people pay attention to and when should they seek medical care?

So basically anyone who has pain in or around the anus, you should not blow it off. Pain or swelling. When one has an infection near the anus, that’s called a perirectal abscess. That is caused by the infected anal gland. And basically, it starts to swell up and it hurts a lot and you can feel a swollen thing. Most people say, “Oh, I have a swollen thing near thing near my butt. that’s probably a hemorrhoid. But the truth is hemorrhoids are sometimes the problem. But there’s a million other things that can cause problems with your behind. But if you have pain or swelling back there, you should just go to a professional. And by a professional, I actually mean a colorectal surgeon who does this for a living. We’re sprinkled throughout the United States and the world, but um, colorectal surgeons are very helpful in this regard. Even though nobody wants to come see us, we’re very, very helpful for this region of the body.

Well, you know, even talking about the “a” word, uh, and sometimes it’s just even hard to say it out loud. Okay, it really is. It really is hard to say anus. I’m embarrassed, [laughter] should just say anus. It’s just a part of the body. It’s just a part of the body.

I find myself avoiding the “a” word as well, but I’m going to say it. It’s my job. Anus.

That’s a part of, well, it is your job. And we’re about to raise awareness about why we should be speaking freely about this.

Because beyond the physical pain, a lot of patients describe this condition as emotionally exhausting and isolating. I wonder if you can talk about the mental and emotional impact that anal fistulas can have on somebody’s daily life and relationships.

Well, that’s a great point and a really good question because anyone with a problem near their bottom, near their anus, first of all, they’re incredibly embarrassed to even come in for help in the first place.

Once they cross that hurdle and come to my office or a colorectal surgeon’s office, even when you find help in that area, you are then probably or you could get surgery in that area. And the surgery sometimes required to fix an anal fistula might require multiple surgeries.

Unfortunately, it’s a kind of a hard problem to fix in a very tricky area that has really important muscles down there. And the muscles of the anal canal are what compromise, that comprise, your continence, your ability to hold on to stool, which is a very important part of being a social being, is that you are not stooling while you are, say working, or socializing or being intimate with a partner. You do not pass stool. So the sphincter muscle is very important and that damn fistula crosses over the sphincter muscles and so it makes it a tricky area to fix.

The fact that it takes multiple surgeries to fix usually turns it into a whole kind of a misery. And that’s I believe why you’re referencing that it can really impact your quality of life. To have pain back there sucks in the first place. To have surgery back there even once or twice absolutely is not fun. And then to have pain and drainage and the multiple surgeries back there can really impact your quality of life. It’s a tough area to have this problem.

Well, you talk about some of the traditional treatments and how difficult and challenging they can be and perhaps not always as effective as you’d want them to be. Now, there’s this new treatment called BioHealx. Tell us about the device and how it works differently from traditional surgical procedures.

So, the BioHealx is a brand-new way to fix anal fistulas and it’s very, very exciting to those of us in the field.

Obviously, if you don’t know anything about anal fistula, you’re thinking, what the hell are we talking about? But for someone who deals with it every day, every week, every month of my life, it’s a very exciting possibility.

I describe it to my patients as a little bottle cap. If a fistula is a tunnel going from the inside of the anus to the outside causing problems – this little BioHealx guy, I describe it as a bottle cap that goes over the inner opening of the fistula tract of the tunnel and it just closes it off. It’s absorbable. It disappears into your tissues over time, over a while, but it’ll close down that fistula and fix the problem with only two operations.

One operation is kind of the setup. You need to do the first operation to kind of set things up for success and then you do the second operation. You put the BioHealx in, and the success rates are kind of astounding. It’s in the 85% range, and there is almost nothing else that we have to fix an anal fistula that is even close to 85%. And the ones that work the best to fix anal fistulas are the ones where you actually have to injure the muscles of the anal canal, like you choose to do that. I used to do that. Very traditional. I had to choose to make injuries to the anal canal muscles in order to get a good fix. This BioHealx is a bottle cap which has great results, 85%, and does not at all impact the muscles of the anal canal. So it really could be a great solution. It is a great solution.

Yeah. I actually checked out, I think you have a YouTube example that has an illustration and animation on how it works.

Yeah.

It’s kind of fascinating. I’m a total nerd, so of course I found it and thought, “How does this thing work?” But the cartoon is pretty good. It shows the bottle cap going on and it closes down the little tunnel. It’s a cool little animation.

Well, it sounds like this is certainly a far cry from traditional ways of treating these anal fistulas and provides a lot better quality of life and outcome. And so I’m so glad we’re talking about this because this is something that I’m sure not a lot of people even are aware of. And even if they have the situation, they may not even realize that there is a solution to it. And so, you are out there raising awareness about these issues.

And you’re doing it in some very interesting ways. You’re not only a colorectal surgeon, you’ve become known online as the Singing Surgeon. And I wonder if you can talk a little bit about why you decided to take this approach to communicating information about an area that I’m sure a lot of people either aren’t very well versed in or are even more uncomfortable talking about.

Well, for me, I’ve been working in this field for 21 years, and it’s a long history of knowing that everyone is petrified to be in my office. Petrified and mortified.

Mortified. Petrified. Both together.

There’s probably some word that’s a nice mashup of those two words, but people do not want to be there. And so, the desire to get out on TikTok.

I became aware of TikTok sort of during the pandemic. And God knows surgeons had a lot more free time during the pandemic because nobody wanted to have any surgery during the pandemic. So honestly, I had free time.

I tried to learn about TikTok. I figured that lots and lots of young people were on TikTok. And honestly, my friend Karen Tang, who is an influencer, who is an OB-GYN, she was out on TikTok doing all this cool stuff. And I said, “If you can do it, I’m going to give it a try.”

And I tried to use humor to get across real information about medical stuff that’s super embarrassing and that nobody wants to talk about. And for me, humor is a huge lever. It’s a huge tool.

It’s also in my DNA. That’s kind of how I’m kind of cracked up. I don’t take myself that seriously, and that’s a good thing in my job. I like to take great care of people and yet not take myself that seriously, and it works well.

So, I figured, could I use humor to make people crack up and then tell them something real and true about a part of the body, the anus, that nobody wants to say the word and nobody knows anything about? And that’s how I started. And I did a few and then kind of petered out.

And then in the last five years, I decided to leverage all of my talents and bring them together. And I decided to sit down at my piano and play little numbers, or like half a song, to get people kind of roped in, like, “What is this guy doing?” And then I switch and I start talking to the camera about different medical things in the colorectal area, in the anorectal area.

And I think I’ve gotten a couple million views on a few things. I don’t claim to be an influencer, but it’s kind of interesting and funny to think that people are out there saying, “This is great. I’ve got Crohn’s disease and I have a fistula and I love Broadway music, so this is my channel. This is my content.”

It’s very, as my kids would say, it’s very niche, but I dabble in TikTok and Instagram to try and get it across to kids.

Well, I would say you definitely qualify as an influencer in that area, and that’s pretty wonderful because we know, first of all, how difficult it is to have conversations about that area of the body. Number one. And number two, as I mentioned before, it seems like young men are more likely to have this condition, and we know how men are. Okay, men do not want to go to the doctor, and they certainly don’t want to talk about that area of their bodies. Right?

That is correct. Men are, I would say, more difficult to take care of for sure because they are more likely to say, “I’m fine,” and not go see anyone.

There are plenty of guys in my office who say the reason I’m here is my wife made me come in because maybe the wife is sick of seeing blood or discharge or infection in the person’s underwear, literally. That happens plenty.

And so, yeah, our wives can sort of boss us around and say, “Hey, take care of yourself.” And we do see that a fair amount. I will say we also see anal fistulas in women and in middle-aged and older folks, but, yep, young men are a large proportion of it as well.

Well, Dr. Pearson, if people want to find out more about your practice, but also if they want to find out more about the BioHealx treatment, how do they find out more?

So, the company that makes the BioHealx device is called Signum Surgical. There’s a website they can go to, Signum Surgical. And that’s the website that has the cool animation. You could also just Google BioHealx.

Those two Google searches will get you all the way to the website with the animation and let you learn a little bit about it. It’s a really pretty good, comprehensive website that talks about fistulas and how BioHealx works.

Well, we’re very glad that you’ve chosen this as your field of interest because clearly, it’s something that’s very needed. It’s a painful and often misunderstood medical condition that affects thousands of people every year, anal fistula, and it has a huge emotional and physical toll on patients and families.

Dr. Philip Pearson, colorectal surgeon and educator known online as the Singing Surgeon, we want to thank you so much for spending the time with us and raising our awareness about an area that people don’t know much about. But there are certainly some solutions, and we’re glad to know that they are out there. Thanks for sharing that with us.

Thank you so much for having me and having the BioHealx device be part of the broadcast. We’re happy that we have something cool to offer that will help people with a very, very embarrassing and kind of miserable problem. So, yeah, raising awareness is always good, and your program can certainly do that. So, we certainly appreciate that.

All right. Thank you so much for joining us, Dr. Pearson. Have a great day.

Thanks so much.