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ANAL FISTULA

BASIC INFORMATION

DESCRIPTION

Anal fistula is a very small tube or tract that leads from

the anal canal (the last part of the rectum) to the skin

near the anal opening. Watery pus drains through this

opening and causes irritation to the skin. Some fistulas

cause no symptoms. Fistulas can affect all ages.
FREQUENT SIGNS & SYMPTOMS

• Discharge from the anus. There may be bleeding.

• Skin irritation or itching around the anus.

• Pain when passing a bowel movement.

• Tender lump near the anus.
CAUSES

• Anal fistulas are usually caused by a prior anorectal

abscess. An anorectal abscess is caused by a bacterial

infection of one of the glands in the anal canal. Some

patients will have both an abscess and fistula.

•Other anal fistulas may be caused by infection, injury

(trauma), disease, or radiation therapy.
RISK INCREASES WITH

• Inflammatory bowel disease (e.g., Crohn’s disease).

•Diverticulitis, tuberculosis, chlamydial infection, large

intestine cancer, HIV infection, certain other disorders,

or radiation therapy.
PREVENTIVE MEASURES

There are no specific preventive measures. Getting

medical care for an anorectal abscess may help.
EXPECTED OUTCOMES

Anal fistula treatment can provide satisfactory results in

most cases. The goals are to heal the fistula, relieve the

symptoms, avoid sphincter muscle problems and other

complications, and prevent fistula recurrence. In some

cases, more than one type of treatment may be needed.

Healing time will vary and may take weeks to months.
POSSIBLE COMPLICATIONS

• Treatment may lead to complications. Some degree of

fecal incontinence (unable to control bowels) may

develop. Pain, infection, bleeding, delayed healing, and

other complications may occur.

• Rarely, a temporary colostomy (feces is diverted to an

outside opening) may be required.

• Anal fistula can recur.
DIAGNOSIS & TREATMENT

GENERAL MEASURES

• Your health care provider will ask questions about

your symptoms and medical history. A physical exam of

the anal area will be done. Medical studies (usually

under anesthesia) are needed for diagnosis. An

anoscope (a flexible tube with a lighted end) is used to

see inside the anus and anal canal. Other tests may be

done for complex fistulas or to look for an underlying

disorder (e.g., Crohn’s). These may include blood tests,

MRI, sigmoidoscopy, x-rays, ultrasound, and others.

• Treatment depends on the results of the medical tests

and exact location of the fistula. Some anal fistulas can

be simple and others are more complex and difficult to

treat. There are several treatment options and each has

benefits and risks. They will be discussed with you.

• Treatment may involve surgery (called fistulotomy or

fistulectomy) to open the fistula. Advancement flap is a

surgical option. Seton procedures use a surgical thread

to allow for fistula draining and healing. Fibrin glue

injection and anal fistula plug are other options.

• At home, sitz baths help relieve discomfort. Sit in a

tub of warm water (not hot) for 10 to 15 minutes several

times a day. Dry the area carefully and completely.
MEDICATIONS

• To prevent constipation, use stool softeners.

• Antibiotics may be prescribed if infection is present.

• Drugs for pain may be prescribed after treatment.
ACTIVITY

You will be advised about resuming work and normal

activities depending on the specific treatment.
DIET

A high fiber diet may be recommended.

NOTIFY OUR OFFICE IF

• You or a family member has anal fistula symptoms.

• Symptoms recur or new symptoms develop after

treatment.
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Contact Info

11109 Surrey Hills Boulevard
Yukon, OK 73099-8155

Phone: (405) 373-2400
Fax: (405) 373-4400

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