Anal Fistula

Introduction to Anal Fistula

Formation of an unusual small pipe-like structure linking an infested mucous gland within the anus to an opening on the skin surrounding the anus is referred to as an “anal fistula” or simply a “fistula”. Clogged anal mucosal glands as well as pus collection in anal tissues (abscess) are the dominant causes of an anal fistula.

Other less responsible disorders, which may lead to fistula are as follows:

  • Crohn’s Disease (a type of inflammatory bowel disease)
  • Radiation therapy in cancer
  • Injury
  • Sexually transmitted diseases, including AIDS
  • Tuberculosis
  • Diverticulitis (Intestinal disorder causing formation of small inflamed pouches in the colon)
  • Malignancy/Cancer

Fistulas can occur in multiple body parts, including artery and vein, bile duct and skin, cervix and vagina, neck and throat, bowel and vagina, etc. They can either be blind, complete, horseshoe-type or incomplete with respect to their structure.

Symptoms of Fistula/Anal Fistula

  • Frequent pus formation in the anal area often leading to discharge of bloody or bad smelling pus from an opening near the anus.
  • Pain, swelling and itching surrounding the anus. When accompanied by pus discharge, the pain subsides after drainage.
  • Painful bowel movements.
  • Fever with chills and an unexplained feeling of tiredness.

Diagnosis of Anal Fistula

If your doctor suspects an anal fistula, he/she will inquire about your medical history and conduct your physical examination. Your doctor will specifically ask you about the symptoms you are experiencing and observe for signs of drainage from the anus. He/she may separate your buttocks and insert his/her finger in your anus to check for the presence of bleeding or pus discharge.

Your doctor may also recommend you to go for radiological exam such as an X-ray or even CT scan.

In doubtful cases for surety, your doctor may also prescribe a colonoscopy exam, wherein, a tube attached with a tiny camera is inserted into your anus to check your bowels from within. This procedure will be performed under anesthesia, to avoid feeling of any pain or discomfort.

Treatment of Anal Fistula

A conservative strategy to treat fistula does not exist currently. Hence, surgical treatment is mandatory for a fistula patient. However, the surgery for fistula is a simple procedure and can be carried out even at your doctor’s clinic.

  • If you have a simple fistula and is not very close to your anus, the doctor will simply incise out the skin and muscles surrounding the pipe (fistula), to permit healing of the opening from within.
  • A plug may be used by your doctor to close your fistula opening
  • In more complicated cases, a tube might be placed by the doctor into the opening to channel out the infected mucous prior to surgery. It could last for 6 weeks or even more.