An anal fistula is a tunnel-like passage between the skin and the anus. An infection causes the appearance of the fistula. The inside of the tunnel is connected to the infected anal gland or sac. Discharge of pus or blood occurs from a fistula that causes pain. The main cause can be an anorectal abscess. Other causes may include Crohn’s disease, diverticulitis, ulcerative colitis, STDs, rectal cancer, post-anorectal surgical complications, chronic constipation, and more.
- Swelling and tenderness in the anal region
- Itching and redness
- Moderate to severe pain while passing bowels
- Pus and/or blood discharge
Surgical intervention can be undertaken after giving local anesthesia, like:
- Fistulotomy :
In this procedure draining through the tunnel is achieved by cutting open the fistula.
- Seton technique :
A seton or surgical thread is left in the fistula for a few weeks for draining and healing. This procedure does not require any cuts or sutures.
- Advancement flap procedure :
After cutting and scraping off the fistula, a flap of tissue taken from the rectum is used to cover the fistula and then allowed to heal.
- Ligation of Inter-sphincteric Fistula Tract (LIFT) :
This procedure treats fistula passing through the anal sphincter muscles. The muscles are moved apart by cutting the skin above the fistula and sealed at both ends.
- Fistula Plug :
This is a bio-absorbable synthetic plug that is placed inside the tract. Over time, it gets absorbed and new cells are formed inside, treating the fistula.
- Fistula-tract Laser Closure (FiLaC) :
FiLaC method removes the fistula without damaging the sphincter muscle. A radially emitting fiber device is inserted at the external opening of the fistula. The laser beam destroys the fistula tract. General anesthesia needs to be administered for this purpose.
- Video Assisted Anal Fistula Treatment (VAAFT) :
is another treatment mode, and does not require surgery. A Futuroscope is inserted in the external opening of the tract. The inner tract is fulgurated and cleaned from the internal opening to the outside.
Dr. Shailesh Matkar
Specialist General Surgeon
What is an anal fistula?
An anal fistula is an abnormal opening near the anal opening of the infected blocked anal gland. This gland fails to drain inside the anal region and forms another external opening near the anus through which it releases its contents.
This abnormal opening called anal fistula does not heal on its own and needs surgical treatment for permanent healing.
What are the symptoms of a fistula?
Symptoms of Fistulas are:
- Constant throbbing anal pain
- Frequent abscesses
- Foul-smelling discharge
- Painful bowel movements with or without anal bleeding
- Anal skin irritation
- Enlarged swollen lymph nodes
These symptoms might go off for some time, but they recur till the permanent healing of the infected gland or tissue connected with the fistula.
Is fistula a serious condition?
Fistulas can cause a lot of discomfort and serious complications if left untreated. All symptoms like anal pain, anal bleeding, fever, and pus discharge will worsen if left untreated. These worsened symptoms can easily hamper the daily routines of the patient.
In advanced cases, fistulas can be a source of infection, which might spread to the whole body and can lead to low blood pressure, organ damage, or even death.
Can a fistula heal on its own?
Mostly fistulas do not heal on their own without medical treatment. They might close for some time due to a decrease in the infection of the tissues but tissue might get infected again and the tract may reopen due to repeated infection. So surgical treatment is necessary to completely heal them and prevent the recurrence of fistulas.
Will a fistula recur?
if proper treatment and care are taken after the fistula treatment, a fistula usually will not recur. A fistula may, however recur if not taken care of by a specialist and experienced colorectal surgeon.
At MEDSTAR, we provide long-lasting fistula healing treatment with the help of our experienced surgeons and newly devised technologies.
How much time fistula take to heal?
It may take 3-12 weeks for the anal fistula to heal completely. The patient has to take complete rest for the first 24 hours after surgery. Usually, the patient can resume daily life routines after 3-5 days post-surgery.
The time taken for the complete healing of the fistula also depends on the medical condition and age of the patient.
What is the most effective treatment for fistulas?
Lasers are the most effective treatment for fistulas. Laser procedures are painless, resulting in excellent fistula healing without post-surgical wounds. These procedures preserve the anal sphincters so that patient can control bowel movement post-surgery. The recurrence rate of the fistula is also low after laser treatment
At MEDSTAR, we have highly skilled surgeons to treat anal fistulas with the use of lasers.