Anal fistula

Information

What is anal fistula?

Perianal fistula is an external opening of a canal, which is a communication between the anus and perianal skin. It results from abscess (pus collection, furuncle) around the anus, opened spontaneously or by surgical incision, but the surgeon could not establish or eliminate the communication with the opening of inflamed anal gland. The following three situations are possible:

1. Fistula is self-healed spontaneously and the patient has no complaints (very rare).

2. Abscess is healed only to appear again after a certain time (in 30%).

3. Abscess is healed but fistula remains and it discharges pus and formation of further fistulas is possible (60%).

Which are the symptoms?

Lesion starts with swelling, pains and inflammation in anal region. The so called abscess or furuncle is formed. It is opened surgically by emergency or without specialized treatment it opens spontaneously. The process is chronificated  and leads to fistula. It starts discharging permanently serous-purulent or serous-bloody secret. If fistula remains opened, it is usually painful. It is possible to be obstructed and then abscess is recurrent, which is strongly painful.

How is diagnosed fistula?

At doctor’s examination usually is noticed the dermal hole of fistula, which at pressing discharges bloody-purulent secret. Often colour photo, anoscopy and/or colonoscopy by fibro-optic device is necessary to establish the colon status

What is the treatment?

Chronic anal fistulas require surgical treatment. It is carried out after evacuation of intestinal content under spinal anesthesia.

Recovery period of non-complicated fistulas is 2 to 4 weeks.