What department should I see for anal fistula?

Written by Yang Dong
Colorectal Surgery Department
Updated on September 08, 2024
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Anal fistula is caused by infection of the anal sinuses and glands. It manifests as hard lumps or cord-like objects around the anus, and may involve recurrent swelling, pain, and discharge of pus. In such cases, it is necessary to consult a colorectal surgeon. Generally, if diagnosed with an anal fistula, surgical treatment is required, as conservative treatment usually does not result in a cure.

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Written by Chen Tian Jing
Colorectal Surgery
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Best treatment method for anal fistula abscess

The best treatment method for anal fistula and perianal abscess is surgical treatment, which is also the only curative method. Conservative treatment using drugs alone can only alleviate local inflammatory symptoms and cannot achieve complete cure. The main surgical method is the cutting and threading technique. This involves threading and ligating the infected area and the sphincter muscle. Through the slow cutting and drainage action of the ligature, the infection focus is removed while protecting the anal sphincter. Postoperatively, it is also important to pay attention to disinfecting and draining the local wound, ensuring proper dressing changes, and preventing poor drainage that could lead to infection or recurrence. It is advised that patients avoid spicy and irritating foods for the first six months after surgery.

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Written by Yang Dong
Colorectal Surgery Department
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Is the probability of anal fistula turning into cancer high?

An anal fistula, formed due to an anal gland infection, carries a higher risk of malignant transformation if the infection and inflammation are recurrent and persistent, particularly over a long period exceeding five years. Therefore, it is strongly recommended that anal fistulas exceeding five years should be given sufficient attention and surgical treatment should be pursued promptly to prevent malignancy.

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Written by Si Li Li
Gastroenterology
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Can colitis cause anal fistula?

If it is chronic colitis, it is possible to cause anal fistulas. Most patients with chronic colitis have symptoms of unformed stools and loose feces. Some feces, which are relatively thin, tend to accumulate in the anal crypts, leading to infection of the anal glands in these areas. The inflammation then spreads to the normal soft tissues around the anus, including subcutaneous tissues, forming perianal abscesses. If a perianal abscess ruptures or is surgically incised to release pus, the external opening and the pus cavity gradually heal and narrow, thus forming an anal fistula. If chronic colitis is diagnosed, it should be promptly diagnosed and treated to prevent the formation of anal fistula.

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Written by Yu Xu Chao
Colorectal Surgery
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Is an anal fistula close to the anus considered high or low position?

In general, anal fistulas close to the anus are considered low anal fistulas. Clinically, anal fistulas are classified as either high or low based on the levator ani muscle as the boundary. Those located above the levator ani muscle are considered high anal fistulas, while those below are considered low anal fistulas. Clinically, the treatment for anal fistulas primarily involves surgical intervention. Options include fistulectomy, which involves the removal of the internal opening and the fistula tract. Post-surgery care may include the use of anal cleansing agents, red oil gauze strips, and golden ointment for dressing changes to promote wound healing. It is important to maintain smooth bowel movements and consume a light diet. High, complex anal fistulas may easily damage the anal sphincter or even the anorectal ring, leading to fecal incontinence. Therefore, during surgery, the thread hanging method may be chosen to avoid excessive damage to the anal sphincter.

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Written by Yu Xu Chao
Colorectal Surgery
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How to reduce swelling when an anal fistula flares up?

An anal fistula flare-up can cause perianal swelling, pain, and discharge of pus and blood. For an anal fistula flare-up, initial conservative treatment with medications is an option, such as sitting baths using anal cleansing agents or potassium permanganate solutions after defecation. The sitting bath should last between five to ten minutes to help reduce swelling and relieve pain. After the bath, topical application of mupirocin ointment or other anti-inflammatory ointments like Golden Ointment may also be used to reduce swelling and inflammation. For severe infections, intravenous or oral antibiotics may be prescribed to reduce inflammation. However, clinically, it is recommended to opt for surgical removal of the anal fistula as early as possible. Early removal of the internal opening and the fistula tract is necessary for a complete cure of the anal fistula. If an anal fistula repeatedly flares up, it can easily lead to the formation of more fistula branches, forming complex anal fistulas, increasing the difficulty of later surgeries and enlarging the wound surface post-operation.