Anal Fistula – Symptoms, Causes & Treatment

What is Anal Fistula?

Anal Fistula is a condition where the skin around the anus becomes inflamed and develops a tunnel-like opening. This tunnel can lead to a chronic infection that may require surgery to repair. This tunnel allows bacteria to enter the body and can cause severe pain. Anal fistulas are most common in people who have Crohn’s disease. Still, they can also occur in people with other conditions such as ulcerative colitis or diverticulitis.

What Causes of Anal Fistula?

Anal fistulas are usually caused by chronic inflammation and infection in the lining around the anus and rectum, which can result from various factors, including:

  • Constipation
  • Diarrhea
  • Infection of the lining around the anus (anal fissure)
  • Inflammation of the tissue inside the rectum (internal hemorrhoids)

What are the Symptoms of an Anal Fistula?

Symptoms of an anal fistula include:

  • Painless discharge from the anus that may be clear, cloudy, or bloody
  • Pain in the lower abdomen, bottom, or perineum
  • Swelling in the area around the anus
  • Persistent itching or burning sensation around the anus
  • Painful bowel movements

How is Anal Fistula Diagnosed?

Anal fistulas are usually diagnosed by a doctor and then confirmed with tests. The following tests may be used:

Physical examination: Thedoctor will examine the anus and rectum to check for abnormalities. They may also ask about the symptoms and do a rectal examination to find out more about the exact location of the fistula.

Rectal exam: A proctoscopy is where a special telescope with a light on the end is used to look inside the anus and rectum. It helps detect an anal fistula so treatment can start as soon as possible. Sometimes, the doctor may recommend additional tests as part of the evaluation. These tests include an ultrasound scan, MRI scan, or CT scan.

Ultrasound scan: This test uses sound waves to create an image of internal structures within the body, such as organs or blood vessels. It may be used during surgery if there is no other way to determine if there’s an anal fistula present and may help guide doctors when trying to repair one surgically by showing them where it is located in relation to nearby organs such as nerves or blood vessels that could otherwise be damaged during surgery.

What are the Risk Factors for Anal Fistula?

The risk factors for anal fistulas include:

  • Age: The older an individual is, the higher their risk for developing new anal fistulas.
  • Gender: Women are more likely to develop anal fistulas than men.
  • Diabetes: This condition increases the risk of developing an anal fistula and other complications related to Crohn’s disease or ulcerative colitis.
  • Anal Fissure is a tear in the lining of the anus.
  • Anal Abscess is an infection in the area between the anus and the rectum.
  • Crohn’s Disease or Ulcerative Colitis, diseases that cause inflammation of the digestive tract.
  • Diarrhea can cause chronic constipation or hard stool that sticks and causes pain when it passes through the anus.
  • Hemorrhoids are swollen blood vessels around the anus that cause pain and bleeding.

What are the Types of Anal Fistula?

There are four main types of anal fistulas.

  • Intersphincteric Fistulas occur at the level of the internal sphincter, which is located between the internal and external sphincters.
  • Transphincteric Fistulas occur at the level of the external sphincter, which is located between the internal and external sphincters.
  • Suprasphincteric Fistulas occur above both internal and external sphincters, usually as a result of trauma to the anus or rectum.
  • Extrasphincteric Fistulas occur outside both internal and external sphincters, usually as a result of trauma to the anus or rectum.

What are the Treatments Available for Anal Fistula?

Anal fistulas are usually treated by a general surgeon, a colorectal surgeon, or a proctologist (an expert in diseases of the anus and rectum). Treatment for anal fistulas may include the following:

Fistulotomy involves cutting out the internal portion of the fistula with a surgical knife or laser beam, allowing normal tissue to grow in its place. It’s usually performed under general anesthesia and requires an overnight stay in the hospital.

Seton Techniques are used to treat anal fistulas. Setons are fine wires placed in the fistula tract to drain pus and fluids from the anal canal. The seton is removed after several months when healing has occurred.

The Advancement Flap Procedure involves creating a new passage for fecal matter to exit the body by moving tissue from one area to another. The advancement flap procedure is typically performed in conjunction with other procedures, such as a posterior sphincterotomy or surgical removal of affected tissues. The advancement flap procedure may also be referred to as a mucosal advancement flap procedure.

The Ligation of Intersphincteric Fistula Tract (LIFT) procedure is a minimally-invasive surgery that involves removing a portion of the intersphincteric fistula tract and then closing it with absorbable suture closure.

Endoscopic Ablation is a minimally-invasive procedure that uses lasers to remove the damaged tissue from around the anus and close off the tunnel. This allows the area to heal and prevents further infection from occurring.

Laser Surgery for anal fistula is a minimally invasive procedure that can be used to treat the condition. It can be performed under local or general anesthesia and often involves only one or two small incisions in the affected area. A laser beam is then used to seal off the openings of the fistula, which helps prevent infection from spreading and relieving symptoms.

Fibrin Glue is a medical adhesive used to treat anal fistulas. Fibrin glue is made from a clotting protein called fibrinogen, extracted from human blood. Fibrin glue can be injected into the anal canal to seal off the fistula and stop the leaking of fecal matter, which causes the symptoms of this condition.


How serious is a fistula?

A fistula is a serious medical condition that can lead to surgery and other complications.

How serious is a fistula?

A fistula is a serious condition that can cause many problems for an individual’s health, both short-term and long-term. It’s important to understand what causes fistulas, how they’re treated and managed, and the potential complications.

Can a fistula heal on its own?

Fistulas can heal on their own, but the rate of healing varies depending on the severity of the condition. Fistulas are not always life-threatening but can be incredibly uncomfortable and require treatment. If an individual has a fistula, they should see their doctor find out how to treat it.

Is fistula a major surgery?

Fistula is not major surgery. The procedure is often performed under local anesthesia; most patients can go home the same day. However, some patients may need to stay in the hospital overnight.

How long does fistula surgery last?

Fistula surgery lasts anywhere from 30 minutes to 2 hours. The length of the procedure depends on how many surgeries an individual has, what type of fistula a persona has, and how complicated the case is.

How painful is fistula surgery?

Fistula surgery is a minimally invasive procedure. It is typically done under general anesthesia, and the patient will spend one to two hours in the recovery room after the surgery is complete.

What food should be avoided in fistula?

One way to avoid worsening a fistula is to avoid foods containing indigestible carbohydrates like roughage or fiber. These include wheat bran, whole wheat bread, cereals, beans and lentils, nuts, and seeds. The problem with these foods is that they can be difficult to digest, which can contribute to bacterial overgrowth in the small intestine, leading to inflammation in the area around the fistula or diverticular abscesses. Fistula pain is a burning sensation that can be felt in the lower abdomen, groin, or rectum. It may be experienced as a constant dull ache or as sharp pains that come and go.

What does fistula pain feel like?

Fistula pain can vary from person to person. Some patients may feel a burning sensation, while others may feel more of an ache or aching sensation. The pain can differ depending on where the fistula is located and how long it has been there.

How do you heal a fistula?

Fistulas can be very painful, but there are several ways to heal them. If there is an open wound, it’s essential to keep it clean and covered with a bandage. One should also avoid walking around in public, as this could expose it to bacteria that can worsen the fistula. If one has an internal fistula, their doctor may prescribe antibiotics or other medications to help treat the infection. One should also consider undergoing surgery if symptoms don’t improve after using antibiotics for several weeks or months. The type of surgery performed will depend on what type of fistula an individual has.

Our expert Proctologists can help manage anal fistula with a combination of medications, procedures, and lifestyle changes. We’ll work with you to identify the best treatment for your needs.

Our Expert Proctologist

Dr. Ibrahim Gamal

Specialist General Surgeon

Years of Experience : 10

Nationality : Eygpt

Languages Known : Arabic , English

Our Experts

See more