What is an Anal Fistula and How Can You Recover from It?
An anal fistula is a chronic abnormal communication between the end of the bowel and the skin near the anus. It originates from the anal glands located between the internal and external anal sphincter. These glands drain into the anal canal, and anal fistulae typically occur in individuals with a history of anal abscesses that do not heal properly.
While anal fistulae are generally not harmful, they can be quite painful and irritating due to the drainage of pus. In some cases, formed stools may also pass through the fistula.
Fistula Symptoms
- Skin irritation around the anus
- Constant, throbbing pain when sitting, moving, or during bowel movements
- Smelly discharge from the opening
- Passing pus or blood during bowel movements
- Swelling, redness around the anus, and sometimes fever if there is an abscess
- Difficulty in controlling bowel movements in some cases
Fistula Causes
- Anal abscesses, Crohn’s disease, diverticulitis, HIV/AIDS, trauma, ulcers, tumors, surgical complications, birth abnormalities, tuberculosis, and cancer in the anorectal region.
Diagnosis of Fistula
Diagnosis is usually done by physical examination, using tools like a fistula probe or imaging techniques like MRI or fistulogram.
- Red opening of the fistula onto the skin
- Pain and tenderness on examination
- Induration or thickening due to chronic infection
- Observation of discharge
Types of Fistula
- Extrasphincteric fistula: Extends from the rectum or colon downwards, passing through muscles like the levator ani, and opens near the anus.
- Suprasphincteric fistula: Arises between sphincter muscles, turns upward, and opens above the puborectal muscles.
- Transphincteric fistula: Develops between internal and external sphincter muscles, opening away from the anus.
- Intersphincteric fistula: Develops between internal and external sphincter muscles, opening near the anus.
