What is an anal fistula?
An anal fistula is a track between the skin on the outside of the buttock/anal area and the anal canal on the inside. There are many different types of fistulae from relatively simple to a complex branching network of tracks. Some fistulae may involve the muscles responsible for bowel control. Each fistula is individual.
The diagram below shows some different types of fistula.
How does the Fistula occur?
A fistula is usually the result of a previous abscess in the area which has been drained but does not fully heal. This results in persistent or intermittent discharge of pus, blood or mucus. There is not usually much pain, although an abscess can sometimes recur.
How do you treat anal fistulas?
Since very few fistulas heal spontaneously, surgery is required in almost all patients with this condition.
Fistula surgery may be simple or complex according to the nature of the fistula. Sometimes it is not possible to see the full extent of the fistula before surgery and so decisions are made whilst you are anaesthetised. Simple fistulas can be ‘laid open’ by cutting a small amount of the anal skin and muscle to open up the track. Fistulas that are situated more deeply (complex fistulas) cannot be treated like this because it would involve cutting too much muscle and could result in incontinence. Here a variety of other treatments are available and your surgeon will discuss the options with you individually.
Complex fistulas are difficult to treat and the surgery may be planned in several stages over a period of weeks, months or even years. Some times these procedures are better done by experts in this area and for further information promptly seek help from a qualified colorectal surgeon with special interest in Proctology.