Anal Fistula
General Surgery
Anal fistula refers to a condition where a channel forms outward between the rectum and the skin near the anus due to bacterial infection and the subsequent formation of pus inside the anal area.
The inner wall of the fistulous tract consists of fibrous tissue and granulation tissue, with the inner end connecting to the anus or rectum and the outer end connecting to the skin near the anus. It is a complication caused by anal abscesses. Depending on the location of the external opening and the course of the fistulous tract within the anal sphincter, it can be classified into two types: complex and simple.
Symptoms
- The Anus area skin has an opening
- The skin around the fistula opening becomes red and inflamed
- Pus, blood, or faeces ooze from the fistula opening
- Rectal and anal pain, especially when sitting or during bowel movements
- Fever
Factors
Anal fistulas are typically caused by infections or inflammations in the anal or rectal region. Anal fistulas can occur at any age, but it more commonly occurs in middle-aged patients, and the proportion of male patients is higher than female patients.
The primary causes include:
| Anal Abscess | One of the most common causes of anal fistulas is anal abscesses. Anal glands, located around the anus, are responsible for secreting mucus to facilitate smooth bowel movements. When these glands become infected or blocked, it can lead to anal abscesses, which may ultimately result in the formation of an anal fistula. |
| Inflammatory Bowel Diseases | Conditions such as Crohn's disease or ulcerative colitis can cause inflammation within the rectum, and this inflammation can spread to surrounding tissues, leading to the formation of an anal fistula. |
| Haemorrhoids | Haemorrhoids are swollen masses or lumps inside the anal canal. When haemorrhoids become infected or inflamed, they may lead to the development of an anal fistula. |
| Other Perianal Infections | Other infections, such as skin diseases, perianal infections, trauma, or cancer, can sometimes also result in the formation of an anal fistula. |
Diagnosis and Treatments
Surgical specialists will examine the skin around the anus to check for symptoms such as redness, pus, bleeding, and more. Suppose a fistula is suspected to be complex or challenging to locate. In that case, doctors may consider using Magnetic Resonance Imaging (MRI) for more accurate and precise observation of the fistula tract between its internal and external openings, providing the most effective treatment for patients.
Anal fistulas do not heal on their own, are typically chronic, and tend to worsen over time. To effectively treat and cure an anal fistula, reduce the risk of recurrence, and avoid causing faecal incontinence, surgery is necessary.
The type of surgery performed depends on the location and complexity of the fistula tract. Still, the primary goal of surgery is to thoroughly remove the anal fistula, prevent a recurrence, and protect the sphincter muscles, as damage to the sphincter muscles can lead to faecal incontinence.
| Simple Anal Fistulas | These can be treated with open surgery (fistulotomy or fistulectomy). In fistulotomy, the surgeon makes a small incision between both internal and external opening of the fistula tract, removing and draining all pus and infected tissue. Fistulectomy involves the complete removal of the entire fistula tract. The wound naturally heals, new tissue grows and fills the wound gap between 3-4 weeks of time. |
| Complex Anal Fistulas | If the fistula is deep, has multiple tracts or openings, it cannot be removed entirely, as doing so would cause too much damage to anal sphincter muscle, which may lead to faecal incontinence. Therefore, alternative surgical methods are necessary:
|
Related Services
Acute Appendicitis
Acute Cholecystitis
Anal Cancer
Related Articles
.jpg)
.jpg)
Here When You Need Us
HEAL Medical
A multi-specialty centre providing premium outpatient services for primary and specialist care.
Sat 9:00am - 1:00pm
Sun & Public Holidays Closed
HEAL Oncology
A boutique oncology centre providing comprehensive day procedure care.
Sat 9:00am - 1:00pm
Sun & Public Holidays Closed
HEAL Aesthetic
A doctor-led aesthetic centre with state of the art treatment devices.
Sat 10:00am - 4:00pm
Sun & Public Holidays Closed
HEAL Fertility
Providing world class reproductive medicine services in a friendly, non-judgemental environment.
Sat 9:00am - 1:00pm
Sun & Public Holidays Closed
HEAL Medical
Sat 9:00am - 1:00pm
Sun & Public Holidays Closed
HEAL Oncology
Sat 9:00am - 1:00pm
Sun & Public Holidays Closed
HEAL Aesthetic
Sat 10:00am - 4:00pm
Sun & Public Holidays Closed
HEAL Fertility
Sat 9:00am - 1:00pm
Sun & Public Holidays Closed