Anal Fistula

An anal fistula is a painful condition that can disrupt your daily life. At North Shore Gastroenterology, our skilled gastroenterologists offer compassionate, expert care for anal fistulas and other colorectal conditions.

A medical illustration of an anal fistula, showing the abnormal tunnel connecting the anal canal to an opening on the skin near the anus

What is an Anal Fistula?

An anal fistula is a small tunnel that forms between the end of the bowel (the anal canal) and the skin near the anus. It typically develops from a previous or current anal abscess—a painful, pus-filled infection. If an abscess doesn't heal completely after it drains, this tunnel can form.

A fistula can cause ongoing drainage, pain, and irritation, and it rarely heals without treatment. Seeking care from a specialist is essential to properly resolve the condition and prevent further complications.

Causes and Risk Factors for Anal Fistula

The most frequent cause of an anal fistula is a clogged anal gland that leads to an abscess. However, certain underlying conditions can also increase your risk of developing a fistula.

Many fistulas form from a gland that has developed an abscess.

This chronic inflammatory bowel disease is a well-known cause of fistulas.

Infection of small pouches in the intestine can sometimes lead to a fistula.

An injury to the anal area can sometimes trigger the formation of a fistula.

Less common causes include radiation treatment for cancer, sexually transmitted diseases, and tuberculosis.

Symptoms of an Anal Fistula

The symptoms of an anal fistula can be persistent and uncomfortable. Because they are similar to other conditions, an accurate diagnosis is essential.

Common signs and symptoms include:

  • Persistent Drainage: Constant or intermittent drainage of pus, stool, or blood from an opening near the anus.
  • Skin Irritation: Redness, soreness, and itching of the skin around the anus.
  • Pain and Swelling: A constant, throbbing pain that may worsen with sitting, moving, or having a bowel movement.
  • Fever and Chills: If the fistula is associated with an active infection or abscess.
  • Bleeding: Occasional bleeding from the fistula opening.

Diagnosing an Anal Fistula

A thorough examination by a specialist is key to diagnosing an anal fistula and determining its exact path.

In many cases, a fistula is visible as an opening on the skin near the anus. The doctor will gently examine the area to assess the tract.

A small instrument is used to look inside the anal canal and rectum to locate the internal opening of the fistula.

For more complex fistulas, an MRI or endoscopic ultrasound may be used. These tests provide detailed images of the fistula tract and surrounding pelvic floor muscles, which is crucial for planning effective treatment.

Treatment Options for an Anal Fistula

The goal of treatment is to eliminate the fistula while preserving the function of the anal sphincter muscles, which are vital for bowel control. Surgical intervention is almost always required.

Treatment options may include:

This is the most common and effective procedure for simple fistulas. The surgeon cuts open the fistula tract, allowing it to heal from the inside out as a flat scar.

For more complex fistulas involving the sphincter muscle, a special thread or rubber band (a seton) may be placed in the tract. This allows the fistula to drain and heal over several weeks or months before a more definitive repair.

In some cases, a flap of tissue may be taken from the rectum or skin to cover the internal opening of the fistula.

A newer technique that involves accessing the fistula tract between the sphincter muscles to close it off.

Find Anal Fistula Treatment in Westlake or Brooklyn, OH

Living with the discomfort of an anal fistula can be challenging, but effective treatment is available. The compassionate specialists at North Shore Gastroenterology are here to provide expert evaluation and guidance.

Call us today at (440) 808-1212 or request an appointment online to schedule a visit.