How to determine if you have an anal fistula

Written by Yu Xu Chao
Colorectal Surgery
Updated on October 30, 2024
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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.

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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.

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Written by Yang Dong
Colorectal Surgery Department
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Consequences of recurrent anal fistulas

If an anal fistula is not treated in time, it may repeatedly occur. If an anal fistula repeatedly occurs, due to local inflammation, pus will spread and infiltrate into the perianal tissues, causing further aggravation of infection. This can then affect the function of the anus, potentially leading to symptoms such as fecal incontinence. Moreover, if an anal fistula repeatedly occurs over a long period, there is a possibility of malignant transformation.

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

If a patient is diagnosed with an anal fistula, it must not be left untreated. If an anal fistula is not actively treated over a long period, it can easily lead to thickening of the fistula tract or an increase in branching. Moreover, after long-term repeated inflammatory stimulation, some fistula tracts are prone to malignant transformations. Therefore, it is recommended that patients with anal fistulas seek symptomatic treatment as soon as they are diagnosed. The primary method of treating anal fistulas is surgical. The main surgical approach for an anal fistula is fistulotomy with seton placement, which involves removing the local fistula tract wall while preserving the function of the patient's sphincter muscle. After the surgery, patients need to follow a light diet to avoid an increase in local secretions, which can lead to inflammatory stimulation and even the recurrence of the anal fistula.

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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 Chen Tian Jing
Colorectal Surgery
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The difference between perianal abscess and anal fistula

Perianal abscesses and anal fistulas both belong to local infectious diseases of the anus. A perianal abscess represents the acute phase of infection, characterized by significant localized subcutaneous swelling, heat, pain, and the formation of pus and abscesses. Once the pus breaks through the skin and discharges, it naturally forms an anal fistula. Anal fistulas represent the later stages or dormant phases of local infections. Both perianal abscesses and anal fistulas require surgical treatment. The surgical method for perianal abscesses mainly involves a one-time radical surgery for the abscess, while the surgical approach for anal fistulas primarily involves fistulotomy with seton placement, followed by regular wound cleaning and dressing changes post-surgery.