Anal fistula: What is it, symptoms, diagnosis and treatment

Anal fistula is an infection that occurs when there is an infection near the anus. Here’s everything you need to know about this condition and how its treated.

Anal fistula, also referred to as fistula-in-ano, is a small tunnel that is formed between the end of the anus and the skin near the anus. This generally occurs when there is an infection near the anus which leads to the formation of an abscess (collection of pus). People suffering from certain diseases such as Colitis, and Crohn’s disease, or undergoing radiation treatment for rectal cancer are at higher risk of developing anal fistula. If not diagnosed at the right time, one can encounter a recurrence of an abscess, and an anal fistula is possible. One should seek immediate treatment after spotting the symptoms. Here’s everything you need to know about anal fistula.

Signs and symptoms of anal fistula

These are the signs and symptoms of anal fistula that you should not ignore:

1. Constant pain

Individuals suffering from anal fistula might feel severe, nerve-wrenching pain around the anus which can cause discomfort. It becomes a challenging task for individuals suffering from anal fistulas even when they sit down, move around, cough, or have bowel moment. This pain is caused due to infection and swelling formed in the tissues around the anus.

Anal fistula: What is it, symptoms, diagnosis and treatment
Anal fistula can lead to excruciating pain in the ass. Image courtesy: Adobe stock

2. Inflammation and redness

People may experience redness, swelling, or inflammation in the area around the anus. This swelling can cause irritation, making your skin tender and sensitive to touch. Some individuals might also notice a lump or tight skin near the anus. Swelling and inflammation is the body’s way of responding to certain infections. It is suggested to avoid frequently touching the infected area.

3. Foul smell

Patients might often notice a strong, foul smell while discharging from the fistula. This foul smell can be highly noticeable when the discharge is heavy or soaked onto the clothes, making individuals change their clothing throughout the day to avoid such an unpleasant smell. This foul smell is caused due to bacteria present in the pus.

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4. Fever

In certain situations, individuals might feel uneasy, and feverish. They may even experience chills, and episodes of vomiting that can cause discomfort.

Diagnosis of anal fistula

Diagnosis is done with a detailed assessment by your doctor. Your healthcare provider will ask your medical history, signs or symptoms you may experiencing, and if previously experienced abscesses near the anus. This information helps your doctor know more about your current situation to go with the best available treatment option. Your doctors might physically examine the infected area around your anus to identify any abnormalities or lump. In some cases, individuals undergo MRI (magnetic resonance imagining), ultrasound, or CT scan (computed tomography) to assess the fistula more clearly.

A woman bending down in pain on the toilet seat
Doctor will access the condition thoroughly to diagnose anal fistula. Image courtesy: Adobe stock

How is Anal Fistula treated?

In most cases, individuals need to undergo surgery for treating anal fistula. This surgery can be simple or complex depending on the severity of the condition. Most individuals undergo simple surgery which can be performed in one go, whereas individuals with complex anal fistula undergo surgery in different stages.

  • Fistulotomy: Fistulotomy is the most common surgical procedure used for treating simple anal fistulas, It involves making an incision to open the entire fistula to allow drainage and let it heal from inside.
  • Seton placement: It is a piece of thread that is placed in the fistula to keep it open and allow the smooth flow of drainage. This surgical method is used for treating complex anal fistulas.

Individuals are advised to do certain lifestyle modifications such as including fresh fruits and vegetables in their diet and avoiding eating spicy food which can easily irritate your fistula.

About the Author

Dr Anil Malik is the General Surgeon and Laparoscopic Surgeon at Apollo Spectra in Delhi. He is a well-qualified surgeon who has expertise in various fields including Gastric Internal Surgery, Gall bladder surgery, Breast Surgery, Piles Surgery, Advanced Laparoscopic Surgery, Cancer Surgery, General Surgery, Laparoscopic Surgery, Minimal Access Surgery, Thoracic Surgery, Hernia Surgery (Laparoscopic), Gallstones (Lap Cholecystectomy) and Anti-Obesity (Laparoscopic Bariatric Surgery).Dr Malik completed his MBBS from Meerut University in 1978, and MS in general surgery in 1982. He also has a fellowship from the Indian Association of Gastrointestinal Endoscopic Surgeons – India, Fellow of International College of Surgeons and Fellow of EATS.To add to his achievements, Dr. Anil Malik has been awarded Gold Medal in MS. He is also the life member of some prestigious organizations like European Association for Transluminal Surgery, Endoscopic Laparoscopic Society of Asia and the Association of Minimal Access Surgeons of India. Read More