What color is the pus from an anal fistula?

Written by Yang Dong
Colorectal Surgery Department
Updated on September 09, 2024
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An anal fistula is a sinus tract and fistula formed from an infection of the anal sinuses and glands. During the infection phase, there is a possibility of swelling, pain, and pus discharge. This discharge may be yellow pus or pus mixed with blood. Regardless of the color, it is crucial to seek prompt medical treatment at a hospital and undergo thorough treatment, rather than attempting conservative treatment on one's own.

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Written by Chen Tian Jing
Colorectal Surgery
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How to deal with the internal opening of an anal fistula?

The internal opening of an anal fistula is generally located at the site of inflammation in the anal crypt. The primary reason for the formation of an anal fistula is the repeated outbreaks at the anal crypt, which lead to further infection and the formation of a perianal abscess. When the abscess cavity ruptures, it forms an external opening and the anal fistula. Surgical treatment is required for the internal opening of an anal fistula, generally involving a seton procedure that threads a line through the internal opening and part of the sphincter muscle, gradually cutting and draining the area slowly. If the inflammation at the internal opening is significant, it may also be necessary to excise part of the infected site in the anal crypt. Post-surgery care of the internal opening of an anal fistula primarily involves dressing changes, requiring daily thorough disinfection of the local area, ensuring clear drainage, to allow the granulation tissue at the internal opening to grow freshly, and to slowly heal the wound without infection. (Medication should be taken under the guidance of a doctor.)

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Written by Chen Tian Jing
Colorectal Surgery
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What department should I go to for anal fistula?

If you suspect you have an anal fistula, it is recommended to register with a proctology department for examination and treatment. The examination of an anal fistula mainly involves digital rectal examination, local perianal ultrasound, and probing with a probe. Typically, an anal fistula will have an external opening in the local anal area, and when the doctor touches near the dentate line of the anal canal with their index finger, an internal opening will be found in the anal crypt. Pressing on the local internal opening will cause secretions to flow out from it. Anal fistulas are relatively easy to diagnose, but further examinations such as perianal ultrasound and pelvic MRI are needed to clarify the direction of the fistula tract and the extent of the lesion. The treatment of an anal fistula primarily involves surgery, using techniques such as fistulotomy with seton placement to remove the local infection.

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Written by Chen Tian Jing
Colorectal Surgery
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Do anal fistulas need surgery even if there are no symptoms?

After the formation of an anal fistula, it does not always lead to acute episodes over a long period. Acute episodes of an anal fistula, causing infectious symptoms, occur only when there is a severe localized damp-heat condition. Therefore, the symptoms of an anal fistula are intermittent. The absence of symptoms does not mean that the anal fistula is completely cured or will not recur. Therefore, if an anal fistula is diagnosed, it is necessary to undergo surgical treatment as soon as possible to avoid repeated episodes due to lack of active treatment. Long-term repeated episodes of an anal fistula can lead to thickening of the fistula wall and an increase in branching. Even if an anal fistula is not actively treated over many years, it may even induce carcinogenesis in the local fistula wall.

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Written by Yang Dong
Colorectal Surgery Department
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What are the symptoms of an anal fistula?

Anal fistula is one of the common diseases in proctology. The most typical symptom of anal fistula is recurrent anal induration, accompanied by swelling, pain, and pus discharge, often with a ruptured external opening. During the quiescent phase, a hard cord can be felt leading from the ruptured external opening to the inside of the anus; during the acute inflammatory phase or abscess phase, pressing may cause pus to ooze from the ruptured opening.

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Written by Yang Dong
Colorectal Surgery Department
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Consequences of recurrent anal fistulas

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.