Consequences of recurrent anal fistulas

Written by Yang Dong

Colorectal Surgery Department

Updated on September 03, 2024

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If an anal fistula is not treated in time, it may repeatedly occur. If an anal fistula repeatedly occurs, due to local inflammation, pus will spread and infiltrate into the perianal tissues, causing further aggravation of infection. This can then affect the function of the anus, potentially leading to symptoms such as fecal incontinence. Moreover, if an anal fistula repeatedly occurs over a long period, there is a possibility of malignant transformation.

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Written by Deng Heng

Colorectal Surgery

54sec

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What are the symptoms of anal fistula?

An anal fistula generally refers to a tract left behind after an anal abscess bursts on its own or is surgically opened. It usually consists of a primary internal opening and a secondary external opening. The main clinical manifestations, or primary symptoms, are: The first is discharge of pus, which occurs due to recurrent infections in the anal fistula; The second is pain. When the external opening is closed, the pus inside cannot drain properly, or when drainage is poor, this leads to accumulation of pus in the fistula tract, causing localized pain; The third is itching. Continuous irritation of the skin around the external opening by pus draining from the fistula tract can cause itching around the anus and may lead to symptoms like anal eczema.

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Written by Chen Tian Jing

Colorectal Surgery

1min 4sec

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Is anal fistula prone to recurrence?

If active anal fistulotomy and thread-drawing surgery are carried out after the onset of an anal fistula, it generally does not recur easily. However, if patients do not pay attention to good dietary and defecation habits after being discharged, it may lead to the reoccurrence of the anal fistula. This is because there are multiple anal crypts within the anal canal, and removing the local anal crypts during this episode does not guarantee that other anal crypts will not become inflamed or infected in the future. Especially when patients consume excessive amounts of chili peppers or alcohol, or when they experience diarrhea, it can potentially trigger another infection of the anal crypts. Therefore, to prevent recurrence of anal fistulas, it is necessary to cultivate good defecation and dietary habits to avoid the reoccurrence of anal fistulas.

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Written by Yang Dong

Colorectal Surgery Department

28sec

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What department should I see for anal fistula?

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

1min 3sec

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Which is more serious, anal fistula or hemorrhoids?

Anal fistulas and hemorrhoids are two different types of common colorectal diseases; neither can be said to be more severe than the other, as the severity of each disease depends on its progression and extent. If it's a simple superficial anal fistula, the severity is generally mild, primarily treated with surgery. However, if a high, complex anal fistula is present, in addition to surgery, a comprehensive pelvic MRI examination is also required to rule out any infections in the deep sphincter and ischioanal fossa. The severity of hemorrhoids primarily involves circular mixed hemorrhoids, or those accompanied by incarceration. If circular mixed hemorrhoids with incarceration occur, it is advisable to undergo surgical treatment as soon as possible to avoid necrosis. If hemorrhoids result in persistent and significant rectal bleeding, surgery should also be performed promptly to prevent anemia in the patient.

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Written by Yu Xu Chao

Colorectal Surgery

1min 15sec

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Are hemorrhoids the same as anal fistulas?

Hemorrhoids and anal fistulas are two completely different diseases. Clinically, hemorrhoids can be divided into mixed hemorrhoids, internal hemorrhoids, and external hemorrhoids. Internal hemorrhoids are often characterized by intermittent, painless rectal bleeding, while external hemorrhoids primarily cause symptoms such as a foreign body sensation in the anus and itching. For the treatment of hemorrhoids, if the condition severely affects the patient's normal life, surgical treatment can be considered, such as external peeling and internal ligation surgery, and internal hemorrhoid banding. Anal fistulas are mainly due to perianal abscesses that rupture spontaneously or are incised and drained, subsequently forming an anal fistula, which causes the patient to experience recurrent perianal swelling pain and pus and bloody discharge. Treatment for anal fistulas can only be surgical, and early surgical intervention tends to result in relatively fast postoperative recovery. The surgery mainly involves the removal of the internal opening and the fistula tract, followed by diligent postoperative dressing changes to promote wound healing.