Piles / Haemorrhoids
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Learn moreAnal Fistula
Fistula Treatment
An anal fistula is an abnormal tract that connects the anal canal to the skin near the anus, usually following an infection or abscess. Fistulas do not close on their own; treatment requires the tract to be properly assessed and dealt with, and at Om Sai Piles Care that assessment comes before any discussion of the procedure.
Overview
Most anal fistulas begin as an infection in one of the small glands inside the anal canal. The infection forms an abscess, the abscess drains — either on its own or after being opened — and the tract that remains behind becomes the fistula.
Patients usually notice a small opening near the anus that discharges pus or blood-stained fluid, often with cycles of swelling and relief. Between episodes it may seem to have healed, which is why many people delay treatment.
Fistulas vary considerably. Some are simple and superficial, others branch or pass through the sphincter muscle. Because the treatment differs and because continence must be protected, careful assessment matters more here than in most anorectal conditions.
Common symptoms
- A small opening or bump near the anus that discharges pus or fluid
- Recurrent swelling and pain that settles when the discharge appears
- Staining of undergarments from persistent discharge
- Itching and irritation of the surrounding skin
- Fever or throbbing pain during an episode of infection
- A history of an anal abscess that was drained earlier
Common causes
- Previous anal abscess or gland infection
- Untreated or incompletely treated anorectal infection
- Long-standing anal fissure with secondary infection
- Inflammatory bowel disease in some patients
- Tuberculosis-related anorectal disease in a small number of cases
- Trauma or previous surgery in the anal region
How it is assessed
- History of abscess, discharge and previous procedures
- Local examination to locate the external opening and trace the tract where possible
- Assessment of the relationship between the tract and the sphincter muscle
- Imaging such as MRI fistulogram or ultrasound when the fistula appears complex or recurrent
- Review of earlier operation notes for patients who have been treated before
Treatment approach
- Control of active infection before definitive treatment is planned
- A procedure appropriate to the type and course of the tract, chosen to protect sphincter function
- Laser-assisted management where the doctor considers it suitable after assessment
- Structured wound care and dressing guidance during recovery, since healing takes time
- Planned follow-up, because recurrence is a genuine risk and is easier to catch early
When you should consult a doctor
- Any persistent discharge from an opening near the anus
- Repeated painful swelling in the same place
- A fistula that has been operated on before and has returned
- Fever with anal pain and swelling, which needs prompt attention
- Discharge with any difficulty in controlling stool or gas
FAQ
Questions about anal fistula
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