Anal fistula treatment refers to the medical interventions and procedures designed to address and manage anal fistulas – abnormal passages or tunnels that form between the inside of the anal canal and the surrounding skin. If left untreated, they can cause discomfort, pain, and potential complications.

This article delves into the treatment of anal fistulas, looking at the causes, symptoms, and surgical and non-surgical options.

Anal Fistula Causes

An anal fistula is a condition caused by an infection close to the anus, which results in the formation of an abnormal tunnel-like passage between the inside of the anal canal and the surrounding skin. Understanding the causes of anal fistulas is critical for prevention and treatment. This section delves into the underlying factors that contribute to the formation of anal fistulas.

1. Anal Abscesses as a Precursor

The vast majority of anal fistulas are caused by a previous anal abscess. An anal abscess develops when a small gland in the anal canal becomes infected, causing pus to accumulate. If the abscess is not treated promptly, it can spread and create a passage, resulting in a fistula. As a result, anal abscesses are a major risk factor for the development of anal fistulas.

2. Inflammatory Bowel Disease (IBD)

Individuals suffering from inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis, are more likely to develop anal fistulas. Chronic inflammation caused by these conditions can weaken the intestinal lining and result in the formation of abnormal connections, such as fistulas, between various parts of the digestive system.

3. Infections and traumatic injuries

Anal fistulas can form as a result of infections or trauma to the anal region. Sexually transmitted infections, tuberculosis, and even simple bacterial infections can all cause infections. Trauma, such as a tear during childbirth or anal surgery, can also play a role in the development of fistulas.

4. The Cryptoglandular Hypothesis

The cryptoglandular theory is a widely accepted explanation for anal fistula development. It implies that the anal glands, which are in charge of producing lubrication for the anal canal, can become blocked and infected. This infection can progress to the formation of an abscess, which, if not treated properly, can develop into an anal fistula.

5. Predisposition and Genetics

While genetics is not a direct cause, it may play a role in predisposing people to anal fistulas. Some people may be predisposed genetically to developing conditions that increase the risk of anal abscesses, such as immune system disorders.

6. Other Underlying Conditions

Certain immune-compromised medical conditions, such as diabetes or HIV/AIDS, can increase the risk of infection and, as a result, the development of anal fistulas. These conditions can impair the body’s ability to fight infections and cause healing to be delayed.

7. Inadequate Healing

Improper healing after anal surgery, injury, or trauma to the anal region can foster the development of an anal fistula. This is especially important for those who have had previous anal surgeries or treatments.

Anal Fistula Symptoms

Recognizing anal fistula symptoms is critical for early diagnosis and treatment. We look at the most common symptoms of anal fistulas to help you better understand and treat this condition.

1. Ongoing Pain and Discomfort

Persistent pain and discomfort around the anal area is one of the hallmark symptoms of an anal fistula. This pain is frequently aggravated by activities like sitting, passing stool, or having a bowel movement. The pain may vary in intensity, but it is a consistent feature of anal fistulas.

2. Pungent-Smelling Discharge

The presence of an unusual discharge is a telltale sign of an anal fistula. This discharge is usually stinky and may contain pus or blood. This is caused by the ongoing infection within the fistula tract. The discharge can irritate and irritate the surrounding skin.

3. Inflammation and redness

The skin around the anus may swell, become tender to touch, and turn red. The body’s immune response to the infection causes this inflammation. Swelling and redness can cause discomfort and make it difficult to sit or move comfortably.

4. Itching and Irritation

Itching and irritation around the anus may occur in some people with anal fistulas. The presence of the discharge, which can come into contact with the surrounding skin and cause discomfort, is frequently blamed for the itching.

5. Repeated Abscesses

Anal abscesses frequently precede anal fistulas. If you’ve had an anal abscess in the past that hasn’t healed completely or that keeps recurring, it could be an indication of an underlying fistula. Pain, swelling, and redness are common symptoms of abscesses.

6. Skin Variations

Skin changes in the anal area may occur as a result of ongoing inflammation and infection. Because of the presence of the fistula tract, the skin may thicken, become more sensitive, or develop small lumps or bumps.

7. High fever and chills

An anal fistula can cause systemic symptoms such as fever and chills in some cases. These symptoms indicate an infection that has spread beyond the localized area and necessitate immediate medical attention.

8. Pain During Bowel Movements

The discomfort caused by anal fistulas can be exacerbated by passing stool. Pain and irritation during bowel movements are common, leading people to avoid or postpone going to the bathroom, which can exacerbate the condition.

9. Difficulties with Bowel Movement Control

Anal fistulas can disrupt normal bowel function in some people. Due to the disruption of the anal sphincter muscle caused by the fistula tract, they may have difficulty controlling bowel movements or leakage of stool.

Anal Fistula Treatment Options

Non-Surgical Procedures

Non-surgical interventions are typically reserved for simple or low-risk anal fistulas. These treatments are intended to relieve symptoms and promote healing without requiring invasive procedures.


In cases where infection is present, antibiotics can aid in infection control and inflammation reduction. However, antibiotics may not be enough to completely heal the fistula.

Seton Placement:

A seton is a thin piece of surgical thread that is passed through the fistula tract. This keeps the tract open, allowing it to heal from within. Seton placement is frequently used to treat complex fistulas or to prepare the fistula for surgery.

Surgical Procedures

Anal fistula surgery is frequently used as the primary treatment for anal fistulas, especially when non-surgical methods have proven ineffective or in cases involving complex fistula tracts. Surgical procedures are designed to remove the fistula tract completely, ensuring proper healing and preventing recurrence. The following are two commonly used surgical procedures:


The surgeon cuts open the entire length of the fistula tract and allows it to heal from the inside out in this procedure. While this technique is effective, it may cause some temporary pain and discomfort during the healing process.

The LIFT Procedure (Ligation of Intersphincteric Fistula Tract) involves identifying and ligating the fistula tract at its internal opening, allowing it to heal without requiring a complete cut. It is especially useful for complex fistulas that involve a large portion of the anal sphincter.

Anal Fistula Treatment Expert Advice

Gaining insights from medical professionals with colorectal health experience provides valuable perspectives on the comprehensive management of anal fistulas.

Tailored Approaches for Optimal Outcomes

Experts emphasize the importance of tailored treatment plans that take into account factors such as fistula complexity, location, and overall health. Patients will receive the most appropriate and effective treatment if interventions are tailored based on these variables.

Timely Intervention for Preventing Complications

Medical professionals emphasize the importance of early treatment in preventing the progression of anal fistulas. Addressing symptoms as soon as possible can help to avoid complications such as chronic abscesses and more serious conditions. Seeking medical attention at the first sign of discomfort is critical for effective management.

Balancing Non-Surgical and Surgical Methods

The interaction of non-surgical and surgical interventions provides a variety of treatment options. While surgery is frequently the only option, non-surgical techniques such as seton placement can be used to prepare the fistula for potential surgical treatment, especially in complex cases.

Holistic Patient-Centric Care

Experts emphasize the significance of comprehensive care that goes beyond the clinical procedure. Because of the condition, patients may experience emotional and psychological stress, emphasizing the importance of a patient-centered approach that includes open communication and support.

Empowering Informed Decision-Making

A key component of successful anal fistula treatment is shared decision-making between patients and medical professionals. Patients can make informed decisions aligned with their personal preferences and values if they are given information about available options, potential outcomes, and associated risks.

Sustained Follow-Up for Long-Term Well-Being

Experts emphasize the importance of ongoing post-treatment monitoring. Regular follow-up with the medical team ensures that the treated fistula heals properly and allows for the early detection of any potential complications, which contributes to the management strategy’s long-term success.

Dr. Kamrava – The Anal Fistula Expert!

If you or a loved one are dealing with the discomfort and challenges posed by an anal fistula, take a step toward comprehensive and effective care by reaching out to Dr. Allen Kamrava. With his extensive expertise in colorectal health, Dr. Kamrava is committed to providing personalized treatment strategies that cater to your unique needs.

Schedule a consultation to discuss your concerns, explore treatment options, and embark on a journey toward effective anal fistula treatment.