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Anal Fistula: Symptoms, Causes, Diagnosis, Treatment

Publisher/Author : Pacific Cross

This post is also available in: Tiếng Việt (Vietnamese)


What is anal fistula?

An anal fistula is a condition that occurs when there is a small tunnel that appears between the end of the bowel and the skin near the anus. The anus is the external opening part of your body which helps expel feces from the body. Generally, inside the anus, there are a lot of small glands.

On this type of condition, one of these glands is blocked by many reasons, an abscess or an infected cavity may happen. Treatment for an anal abscess is surgical drainage, although some drain spontaneously. Approximately 50% of these abscesses may develop into a fistula.

Though anal fistulas can cause unpleasant symptoms (such as discomfort and skin irritation, and won’t usually get better on their own), it is not a complicated condition. Surgery is recommended in most cases.

How common is anal fistula?

Please discuss with your doctor for further information.


What are the symptoms of anal fistula?

The common symptoms of anal fistula are:

  • A constant, throbbing pain that may be worse when you sit down, move around, have a bowel movement or cough
  • Smelly discharge from near your anus
  • Passing pus or blood when you poo
  • Swelling and redness around your anus and a high temperature (fever), if you also have an abscess
  • Difficulty controlling bowel movements (bowel incontinence) in some cases
  • Skin irritation around the anus

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • Recurrent anal abscesses
  • Pain and swelling around the anus
  • Pain with bowel movements
  • Bleeding
  • Bloody or foul-smelling drainage (pus) from an opening around the anus. The pain may decrease after the fistula drains.
  • Irritation of the skin around the anus due to persistent drainage
  • Fever, chills, and a general feeling of fatigue. (However, these may be symptoms of many conditions.)


What causes anal fistula?

It is believed that an anal abscess is often the main cause which leads to anal fistula. They can occur if the abscess doesn’t heal properly after the pus has drained away. Less common causes of anal fistulas include:

  • Crohn’s disease

A long-term condition in which the digestive system becomes inflamed

  • Diverticulitis – infection of the small pouches that can stick out of the side of the large intestine (colon)
  • Hidradenitis suppurativa – a long-term skin condition that causes abscesses and scarring
  • Infection with tuberculosis (TB) or HIV

A complication of surgery near the anus

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is anal fistula diagnosed?

If your doctor suspects you experience anal fistula, he/she will do a rectal examination, but some patients may require additional tests to screen for:

  • Sexually transmitted infections
  • Inflammatory bowel disease
  • Diverticular disease
  • Rectal cancer
  • In rare cases, an examination may be done under anaesthesia. The doctor may also arrange for an ultrasound, a CT scan or an MRI to be done.

How is anal fistula treated?

If left untreated, anal fistulas usually require surgery as they rarely heal.

The main options include:

  • Afistulotomy

a procedure that involves cutting open the whole length of the fistula so it heals into a flat scar

  • Seton procedures

where a piece of surgical thread called a seton is placed in the fistula and left there for several weeks to help it heal before a further procedure is carried out to treat it

  • Other techniques

including filling the fistula with special glue, blocking it with a special plug, or covering it with a flap of tissue

All these procedures have different benefits and risks. You can discuss this with your surgeon.

Many people don’t need to stay in hospital overnight after surgery, although some may need to stay in hospital for a few days.

Lifestyle changes & home remedies

What are some lifestyle changes or home remediesthat can help me manage anal fistula?

The following lifestyles and home remedies might help you cope with anal fistula:

  • Try to have a fiber rich diet. It is good to have fibers in ones meal as they aid digestion and bowel movements. The blood cholesterol is decreased and bowel integrity is maintained along with health.
  • Drink a lot of water. Water is always known to help in digestive process.
  • Use stool softeners. It is also important to keep the affected area clean. One can use moist pads to clean the regions. This way infection can be avoided because of exudates from the fistula in ano.
  • The skin is also affected due secretions. Healthcare experts suggest that the patient can use skin creams which are made specially to create a soothing effect on the tissues.

If you have any questions, please consult with your doctor to better understand the best solution for you.

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