Is an anal fistula close to the anus considered high or low position?

Written by Yu Xu Chao
Colorectal Surgery
Updated on November 27, 2024
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In general, anal fistulas close to the anus are considered low anal fistulas. Clinically, anal fistulas are classified as either high or low based on the levator ani muscle as the boundary. Those located above the levator ani muscle are considered high anal fistulas, while those below are considered low anal fistulas. Clinically, the treatment for anal fistulas primarily involves surgical intervention. Options include fistulectomy, which involves the removal of the internal opening and the fistula tract. Post-surgery care may include the use of anal cleansing agents, red oil gauze strips, and golden ointment for dressing changes to promote wound healing. It is important to maintain smooth bowel movements and consume a light diet. High, complex anal fistulas may easily damage the anal sphincter or even the anorectal ring, leading to fecal incontinence. Therefore, during surgery, the thread hanging method may be chosen to avoid excessive damage to the anal sphincter.

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Written by Chen Tian Jing
Colorectal Surgery
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Will anal fistula cause bleeding during bowel movements?

If an anal fistula occurs, during the acute phase of the anal fistula, or when the internal and external openings of the anal fistula are ulcerated, there may also be bleeding during defecation. However, the bleeding from defecation due to an anal fistula is generally minor, and occasionally pus may also be discharged from the anus, or pus may be discharged from the external opening, causing itching or stinging of the skin around the external opening. If local pain or bleeding from defecation occurs with an anal fistula, prompt local anti-inflammatory treatment is needed; an anti-inflammatory ointment can be chosen for local application. However, the fundamental treatment for an anal fistula still requires surgery. It is generally recommended to directly perform a fistulotomy with seton placement to completely heal the fistula and prevent recurrent episodes.

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Written by Deng Heng
Colorectal Surgery
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What are the symptoms of anal fistula?

An anal fistula generally refers to a tract left behind after an anal abscess bursts on its own or is surgically opened. It usually consists of a primary internal opening and a secondary external opening. The main clinical manifestations, or primary symptoms, are: The first is discharge of pus, which occurs due to recurrent infections in the anal fistula; The second is pain. When the external opening is closed, the pus inside cannot drain properly, or when drainage is poor, this leads to accumulation of pus in the fistula tract, causing localized pain; The third is itching. Continuous irritation of the skin around the external opening by pus draining from the fistula tract can cause itching around the anus and may lead to symptoms like anal eczema.

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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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Does an anal fistula hurt?

Anal fistula mainly refers to the presence of a noticeable fistula in the tissue under the perianal skin, which connects the inner opening in the anal canal and the outer opening around the anus. Usually, the anal fistula does not cause significant pain when it is not in acute flare-up. However, if the anal fistula enters an acute episode, there may be pain due to inflammation at the local external opening of the anus, and possibly an increase in purulent discharge, which can irritate the skin around the external opening, causing stinging pain and itching. To prevent recurrent episodes of anal fistula and further aggravation of the condition, it is advised to seek surgery as soon as the fistula is detected.

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Written by Yang Dong
Colorectal Surgery Department
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What department should I see for anal fistula?

Anal fistula is caused by infection of the anal sinuses and glands. It manifests as hard lumps or cord-like objects around the anus, and may involve recurrent swelling, pain, and discharge of pus. In such cases, it is necessary to consult a colorectal surgeon. Generally, if diagnosed with an anal fistula, surgical treatment is required, as conservative treatment usually does not result in a cure.