Eating and excreting solid wastes from the body are natural procedures in our daily life cycle. These are the wastes left after absorbing water content and nutrients from the food we eat by our body. Finally, the wastes are collected in your rectum and excreted out of your body through the anus.

Several crypts and glands are located inside the anus. When any of these pockets become clogged with stool or any other fluids, the buildup of bacteria can infect the tissue, resulting in swollen pockets. This is often called an anorectal abscess by doctors.

The abscess will grow if not treated. Eventually, it will make a way to come out by making a hole in your skin close to the anus so that the pus inside can drain out. The fistula forms here which is a tube-like structure that joins the gland to the outer opening.

Causes of Anal Fistula 

An abscess usually leads to a fistula. Rarely, they can also be caused by diseases like:

  • Tuberculosis (TB)
  • Sexually transmitted diseases (STDs)
  • Crohn’s disease
  • Radiation (cancer treatment)
  • Ulcerative colitis that affects your bowels
  • Trauma
  • Diverticulitis
  • Hidradenitis suppurativa
  • Cancer

Symptoms of an anal fistula

  • The skin around the anus is irritated
  • A constant, sharp pain that might become even more worse when you sit, walk around, poo or cough
  • Foul smell coming from your anus
  • Pus or blood in the faeces
  • Swelling and redness around your anus
  • High fever if you also have an abscess
  • Bowel incontinence

The fistula end may appear as a small hole in your skin surrounding your anus, but you may not be able to see it.

Treatment for anal fistula

Usually, anal fistulas require surgical treatment to eliminate them because they rarely heal without treatment.

The aim of this surgery is to get rid of the fistula without harming the anal sphincter muscles, which could result in incontinence if damaged.

A fistulotomy is a surgical procedure performed to treat fistulas without or with a little amount of sphincter muscle. In this surgery, the fistula tunnel is converted into an open groove by cutting the skin and muscle over the tunnel. So that the fistula tract heals from the bottom up into a flat scar.

Seton procedures are used to treat more complex fistulas. The process involves placing a seton (surgical thread) and leaving it for a few weeks in order to allow it to heal before performing another procedure:

  • A fistulotomy
  • An advancement flap procedure 
  • A lift procedure

Every procedure has its own advantages and risks. Some fistulas might need to be operated multiple to remove it. To know more detailed information consult Dr. Karunakar Reddy, Gastroenterologist at Mathrusri Hospital, Hyderabad.