Understanding Anal Fistulas

What is an Anal Fistula?

An anal fistula is an abnormal tunnel connecting the anal canal to the skin around the anus. This condition typically develops from an infection in an anal gland that creates an abscess, which then forms a tunnel as it drains.

Common Symptoms

• Persistent pain around the anal area
• Redness and swelling around the anus
• Discharge of pus or blood
• Irritation of surrounding skin
• Discomfort during bowel movements
• Fever in some cases

Causes and Risk Factors

Primary Causes

• Anal gland infection (most common)
• Crohn's disease
• Previous anal surgery
• Trauma to the area

Risk Factors

• History of anal abscesses
• Inflammatory bowel disease
• Diabetes
• Compromised immune system

Diagnosis

Physical Examination

• Digital rectal examination
• Visual inspection of the area

Diagnostic Tests

• MRI scan
• Fistulography
• Endoanal ultrasound
• Anoscopy

Treatment Options

Conservative Management

• Sitz baths
• Antibiotics when infection is present
• Pain management

Surgical Options

1. Fistulotomy: Opening and draining the fistula tract
2. Seton placement: Placement of a surgical thread to drain the fistula
3. LIFT procedure: Ligation of intersphincteric fistula tract
4. Fibrin glue: Sealing the fistula with special adhesive

Recovery and Prevention

• Keep the area clean and dry
• Follow proper hygiene practices
• Attend all follow-up appointments
• Complete prescribed medications

When to Seek Medical Attention

• Increased pain or swelling
• Fever above 101°F (38.3°C)
• Heavy bleeding
• Significant increase in drainage

Long-term Outlook

With proper treatment, most anal fistulas can be successfully managed, though recovery time varies. Some patients may require multiple treatments for complete resolution.