What are the consequences of not treating an anal fistula?

Written by Chen Tian Jing
Colorectal Surgery
Updated on March 22, 2025
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If an anal fistula is not promptly treated with surgery, it may lead to an increase in the number of local branches or a thickening of the fistula wall. If the branches of the anal fistula extend to the ischiorectal fossa, it may also lead to pelvic infections. Moreover, if the anal fistula persists for a long time or if there is significant local inflammatory stimulation, it may even lead to cancerous changes in the fistula. Therefore, once an anal fistula is discovered and diagnosed, it is recommended to promptly undergo surgical treatment with fistulotomy and seton placement. Post-surgery, it is crucial to ensure thorough disinfection of the local wound, debridement, and dressing changes, which are very important for the recovery of the wound. This helps prevent pseudohealing, ensuring that the anal fistula heals completely and preventing recurrent episodes.

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Written by Yu Xu Chao
Colorectal Surgery
1min 11sec home-news-image

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.

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Written by Deng Heng
Colorectal Surgery
41sec home-news-image

How long does it take for an anal fistula to form?

An anal fistula is a tract left after an anal abscess bursts spontaneously or is surgically drained, generally consisting of a primary internal opening, a fistula tract, and a secondary external opening. Thus, an anal fistula and an anal abscess represent two stages of the same disease: initially, there is an anal abscess, and then, after the pus from the abscess is drained, an anal fistula forms. Typically, the transformation from an anal abscess to an anal fistula takes about two to three months, meaning that an anal fistula can form about three months after the abscess bursts.

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Written by Yu Xu Chao
Colorectal Surgery
1min 11sec home-news-image

What are the consequences of not treating anal fistulas?

Since an anal fistula is caused by the infection and inflammation of the anal glands, it connects the rectum or anal canal with the skin around the anus, forming repeated abscesses, pain, and discharge of pus and blood around the anus. If an anal fistula is not treated, more fistula tracts will develop over time, and more of the muscles around the anus will become infected. This can even lead to high, complex anal fistulas, making surgical treatment later on more difficult and could easily lead to anal incontinence. Also, if an anal fistula is left untreated for a long time, there is the possibility of malignant transformation. Therefore, in clinical practice, it is recommended to undertake surgical treatment for anal fistulas as early as possible. The surgery for an anal fistula mainly involves the removal of the internal opening and the fistula tract, which is essential for a complete cure. Postoperatively, it is necessary to persist in changing dressings to avoid infection or pseudohealing at the wound site. Moreover, patients should be mindful of their diet.

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

What are the consequences of not treating an anal fistula?

If an anal fistula is not promptly treated with surgery, it may lead to an increase in the number of local branches or a thickening of the fistula wall. If the branches of the anal fistula extend to the ischiorectal fossa, it may also lead to pelvic infections. Moreover, if the anal fistula persists for a long time or if there is significant local inflammatory stimulation, it may even lead to cancerous changes in the fistula. Therefore, once an anal fistula is discovered and diagnosed, it is recommended to promptly undergo surgical treatment with fistulotomy and seton placement. Post-surgery, it is crucial to ensure thorough disinfection of the local wound, debridement, and dressing changes, which are very important for the recovery of the wound. This helps prevent pseudohealing, ensuring that the anal fistula heals completely and preventing recurrent episodes.

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.