Anal Fistula

What’s an anal fistula?

An anal fistula is an abnormal tract, or tunnel, that develops between the skin near your anus and the end of your bowel or rectum.

In many cases, a fistula develops due to an infection in the anal sweat gland, which causes pus to collect in the surrounding tissue. As the pus drains away, the small tunnel remains intact.

Other causes of anal fistula include:

• Anal abscesses
• Crohn’s disease
• Surgical complications
• Hidradenitis suppurativa (a skin infection)

For women, a tract or abnormal connection between the rectum and the vagina known as a rectovaginal fistula can develop between the lower part of the large intestine and the vagina. This condition can cause stool or gas to pass directly through the vagina and is common in women with Crohn’s disease or due to injuries suffered during childbirth.

What are the symptoms of an anal fistula?

While an anal fistula might not be visible, a small hole could form in the skin around your anus. More noticeable symptoms of a fistula can include:

• Anal irritation
• Rectal bleeding
• Throbbing anal pain
• Seepage and discharge

In many cases, an anal fistula can produce a foul-smelling discharge and you could experience difficulties controlling your bowel movements.

For women with rectovaginal fistulas, vaginal pain, irritation, and discharge are common.

Also one may pass stool or flatus through the vagina.

How are anal fistula diagnosed?

Your Progressive Surgical Care physician first reviews your medical history and performs a physical exam to ensure other conditions aren’t causing your symptoms.

To confirm an existing anal or rectovaginal fistula, your physician could do a digital rectal exam or request an imaging test like an MRI or ultrasound. The Progressive Surgical Care team also offers a specialized lighted telescope device, known as an anoscope or proctoscope, that can explore the lining of your anus to identify a fistula, tract, sinus, or hole.

What treatments are available for an anal fistula?

To alleviate the symptoms of an anal fistula, your Progressive Surgical Care physician could recommend surgery to drain pus and remove the sinus tract. In some cases, your physician might use a fibrin glue to seal the fistula tunnel. Advancement flaps can cover or close the defect and cure the fistula.

If any part of your anal sphincter is involved, your Progressive Surgical Care surgeon may needs to place a stitch (vessel loop) to ensure drainage and the formation of a scar. You would then need an additional procedure to safely treat the fistula.

Anal irritation or discharge can be the first sign of an anal fistula. For a diagnostic evaluation, call the office nearest you or book an appointment online today.