Can anal fistulas be left untreated?

Written by Chen Tian Jing
Colorectal Surgery
Updated on May 28, 2025
00:00
00:00

If an explicit diagnosis of anal fistula is made, it cannot go untreated. If the anal fistula is localized around the anus but not actively treated and surgically removed, it is very likely to cause branching of the fistula tract or spread to the ischioanal fossa, as well as thickening of the fistula wall. This can exacerbate the symptoms of local infection, causing an increase in stabbing pain or purulent secretions. Prolonged, recurrent episodes of anal fistula may also lead to carcinogenic changes in the fistula wall due to inflammatory stimuli. Therefore, once an anal fistula is diagnosed, it is necessary to promptly undergo surgical treatment with fistulotomy and seton placement to prevent the condition from worsening and complicating later treatments.

Other Voices

doctor image
home-news-image
Written by Chen Tian Jing
Colorectal Surgery
48sec home-news-image

What should I do about an anal fistula?

Anal fistula is a disease that occurs when repeated infections in the anal crypts extend to the surface of the skin around the anus. Once formed, there are typical fistula tracts with both internal and external openings. Simple anti-inflammatory drug treatments can only relieve the symptoms of inflammation during the acute phase of an anal fistula. For the fistula tracts themselves, these treatments do not completely cure the condition. It is recommended that patients with an anal fistula undergo a fistulotomy as soon as they are diagnosed. Through surgery, the fistula tract and its walls can be completely excised, completely removing the local lesion, thereby further accelerating the regrowth of fresh granulation tissue locally.

doctor image
home-news-image
Written by Yang Dong
Colorectal Surgery Department
32sec home-news-image

causes of anal fistula

Anal fistula is one of the common diseases in proctology. The formation of an anal fistula is caused by infection of the anal sinuses and anal glands. Due to damage to the anal sinuses and anal glands, bacteria from the intestines enter these areas. As immunity weakens, the bacteria cause localized inflammation, which then leads to the formation of an abscess. After the abscess bursts, an anal fistula forms. This is the pathogenesis of anal fistula.

doctor image
home-news-image
Written by Chen Tian Jing
Colorectal Surgery
1min 5sec home-news-image

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.

doctor image
home-news-image
Written by Deng Heng
Colorectal Surgery
44sec home-news-image

Does an anal fistula require surgery?

The treatment of anal fistula mainly focuses on surgical treatment, with medication as a secondary support. This means that without surgery, an anal fistula essentially cannot heal. Non-conservative treatments for anal fistulas are only temporary symptomatic treatments that manage the condition and alleviate clinical symptoms. For example, during an acute attack of an anal fistula, anti-inflammatory drugs can be used to temporarily relieve symptoms such as pain. Therefore, surgery is necessary for anal fistulas, as surgical treatment can completely eradicate the source of the disease, addressing the internal and external origins of the fistula for a complete cure.

doctor image
home-news-image
Written by Yu Xu Chao
Colorectal Surgery
1min 17sec home-news-image

How to determine if you have an anal fistula

First, you can judge whether you have an anal fistula based on symptoms. Patients with anal fistula often experience recurrent perianal swelling and pain, as well as discharge of pus and blood, which may also have a foul odor, with secretion often found on their underwear. In such cases, patients should consider whether they have an anal fistula. Additionally, patients with anal fistulas in the early stages often have perianal abscesses, which generally tend to form fistulas after the abscess ruptures spontaneously or is surgically drained. Patients can also visit the colorectal surgery department of a hospital for a digital rectal examination, where the fistula tract and the internal opening can be felt. MRI scans of the perianal region can also be performed to determine the type and severity of the anal fistula. Clinically, once an anal fistula is detected, it is advisable to opt for fistula excision surgery to completely cure the anal fistula by removing the internal opening and the fistula tract. Post-surgery, it is essential to persist with dressing changes to avoid wound infection and bleeding.