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

Written by Deng Heng
Colorectal Surgery
Updated on November 29, 2024
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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 Chen Tian Jing
Colorectal Surgery
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How long does it take to recover after surgery for an anal fistula?

After surgery for an anal fistula, the general recovery time is about twenty days to a month. The duration of recovery mainly depends on the size of the local lesion before surgery, as well as the surgical wound postoperatively, and also relates to the patient's constitution. Particularly, if the patient has certain underlying diseases, such as diabetes or a history of tuberculosis, the recovery time may be relatively extended. The wound after an anal fistula surgery is an open wound contaminated with bacteria, so postoperative wound dressing changes are very important for wound recovery. It is recommended that the secretion from the local wound be cleared daily, followed by disinfection with povidone-iodine, then application of an anti-inflammatory ointment, and covering the wound with an oil gauze strip for drainage to avoid poor drainage leading to false healing of the local wound.

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Written by Yang Dong
Colorectal Surgery Department
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Anal fistula etiology

The cause of an anal fistula is due to infection of the anal glands. In normal human anatomy, there is a location at the junction of the rectum and the anal canal called the anal sinus or anal gland, which is relatively weak. If it is damaged, intestinal bacteria can enter the anal gland, causing inflammation. Over time, the infected anal gland leads to further abscesses towards the perianal space, causing a perianal abscess. After the perianal abscess ruptures, it further develops into an anal fistula.

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Written by Yu Xu Chao
Colorectal Surgery
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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.

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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 Yu Xu Chao
Colorectal Surgery
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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.