Overview

Anal fistula is the medical term for an infected tunnel that develops between the skin and the muscular opening at the end of the digestive tract (anus).

Most anal fistulas are the result of an infection that starts in an anal gland. This infection results in an abscess that drains spontaneously or is drained surgically through the skin next to the anus. The fistula then forms a tunnel under the skin and connects with the infected gland.

What are the symptoms of an anal fistula?

The signs and symptoms of an anal fistula include:

• Frequent anal abscesses
• Pain and swelling around the anus
• 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 from drainage
• Pain with bowel movements
• Bleeding
• Fever, chills and a general feeling of fatigue

What are the treatments for an anal fistula?

Surgery is almost always necessary to cure an anal fistula. The goal of the surgery is a balance between getting rid of the fistula while protecting the anal sphincter muscles, which could cause incontinence if damaged.

Fistulas in which there is no or little sphincter muscle involved are treated with a fistulotomy. In this procedure, the skin and muscle over the tunnel are cut open to convert it from a tunnel to an open groove. This allows the fistula tract to heal from the bottom up.

In the case of a more complex fistula, the surgeon may have to place a special drain called a seton, which remains in place for at least 6 weeks. After a seton is placed, a second operation is almost always performed:

How much Time Duration is required for Anal Fistula Surgery?

Fistula surgery is usually done on an outpatient basis, which means the patient can go home the same day. Patients who have very large or deep fistula tunnels may have to stay in the hospital for a short time after the surgery. Some fistulas may require several operations to get rid of the fistula.

Is any follow-up treatment necessary for an anal fistula?

Most fistulas respond well to surgery. After the surgery, your surgeon may recommend that you soak the affected area in a warm bath, known as a sitz bath, and that you take stool softeners or laxatives for a week.

Since you may also have some pain or discomfort in the area after surgery, your physician will usually inject local anesthetic such as lidocaine to decrease your discomfort, and may prescribe pain pills. If opioids are prescribed, they are usually used for a very short period.