Can anal fistulas be contagious?

Written by Deng Heng
Colorectal Surgery
Updated on April 06, 2025
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An anal fistula is a pathological channel that forms a connection between the anal canal, rectum, and the skin around the anus. It primarily develops from an infection causing a perirectal abscess around the rectal anal canal. These infections are generally purulent, with a smaller number due to tuberculosis. Other specific infections, such as Crohn's disease or ulcerative colitis, can also lead to anal fistulas. Generally, such infections are caused by Escherichia coli, leading to purulent infections; tuberculosis can be contagious, but generally, it is not infectious or contagious.

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Written by Yang Dong
Colorectal Surgery Department
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What color is the pus from an anal fistula?

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 Yang Dong
Colorectal Surgery Department
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What is the most accurate test for anal fistula?

As a common disease in proctology, simple anal fistulas can be diagnosed through visual inspection and palpation. For high-positioned complex anal fistulas, which cannot be accurately assessed through just visual inspection and palpation, the use of instruments may be necessary. Currently, magnetic resonance imaging (MRI) is recommended as the most accurate method for evaluating anal fistulas, and it is considered the gold standard for examining the course of the fistula tract and the location of the infection.

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Written by Chen Tian Jing
Colorectal Surgery
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Can anal fistulas be left untreated?

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.

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Written by Chen Tian Jing
Colorectal Surgery
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What is the best treatment for anal fistula?

The primary treatment method for anal fistulas is surgery, which mainly involves the use of a local seton thread. This method allows the surgeons to excise or remove the affected area of the anal fistula while preserving the normal contractile function of the local anal sphincter. This precaution helps prevent excessive removal that could lead to sphincter relaxation or excessive loosening of the anus. As the local sphincter naturally repairs itself and the seton falls out post-surgery, it ensures the proper healing of the local wound. Postoperative care for anal fistula surgery also involves proper drainage and disinfection of the local wound. Daily application of oil gauze and changing of anti-inflammatory medications on the local wound are recommended. This helps in reducing inflammation and facilitating drainage, thereby preventing the occurrence of local pseudohealing.

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Written by Yu Xu Chao
Colorectal Surgery
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What are the precautions after undergoing anal fistula surgery?

Because anal fistula surgery primarily involves removing the internal opening and the fistula tract, the postoperative wound is relatively large. Postoperative care mainly requires consistent dressing changes to ensure the wound drainage remains unobstructed, avoiding infection or false healing. Additionally, patients should develop good bowel habits, maintain smooth bowel movements, and avoid withholding stool. Otherwise, this may lead to dry, hard stools, causing severe pain during defecation or damaging the wound, which could result in bleeding or edema. In terms of diet, patients should choose foods rich in roughage to ensure smooth defecation and eat foods rich in high-quality protein to supplement the amino acids the body needs, promoting wound healing as much as possible. Moreover, after surgery, patients must use an anal wash or potassium permanganate solution for sitz baths. Since the postoperative wound is open and contaminated, changing dressings is especially important.