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An anal fistula is an abnormal tract between the anal canal and the surrounding skin, usually resulting from a previous infection, which can cause pain and persistent discharge.
An anal fistula is a small tunnel or tract that forms between the inside of the anal canal and the skin surrounding the anus. It is generally the result of a previous infection of the anal glands that leads to the formation of an abscess (an infected cavity filled with pus) which, when drained, leaves this permanent channel.
The main symptoms include:
Constant or intermittent pain in the anal area, which may worsen when sitting, during bowel movements, coughing, or sneezing.
Drainage of pus, yellowish fluid, or blood from an opening near the anus, which may stain underwear.
Irritation of the skin around the anus due to the drainage.
Swelling or redness around the anus.
Sensation of a moist anus.
Recurrent episodes of abscesses (inflammation and accumulation of pus) in the same area.
Fever and general discomfort if a new infection or abscess develops.
The most common cause is an infection in the anal glands, but other possible causes include:
Diagnosis and Treatment
The diagnosis is made by a coloproctologist through a physical examination of the anal area.
Definitive treatment for an anal fistula is usually surgical intervention. Creams or topical medications only relieve symptoms temporarily and do not cure the fistula on their own. The goal of the surgical procedure is to remove the fistula or open the tract so that it can heal properly.
The fistulous tract may cross one or both anal sphincters, putting anal continence at risk, which is why treatment in expert hands is essential.
The fistula can also be treated with platelet-rich plasma (PRP) in cases with high surgical risk, avoiding sphincter section.
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