Anal Fistula

Anal Fistula

WHAT IS AN ANAL FISTULA?

An anal fistula is an abnormal connection or tunnel between the anorectal canal and the perianal skin that typically results after the development of an anal abscess. The presence of this tunnel or tract may cause intermittent swelling and drainage.  

At Loma Linda University Health, we’re here to assist you. From the moment you contact us regarding this condition, we do everything we can to make sure your treatment runs smoothly. Our goal is to make your experience as convenient, comfortable and stress-free as possible.

WHAT ARE THE SYMPTOMS OF ANAL FISTULA?

Symptoms of an anal fistula include:

• Red, itchy skin near the anus or pain in the anal area
• Pain in the anal area
• There may be pus or other drainage coming from an opening at or near the anus
• Fever and chills

WHAT CAUSES ANAL FISTULA?

Anal fistula can be caused by:

• Complications from an anal abscess
• Trauma to the anorectal area
• Complications following pelvic surgery
• Sexually transmitted diseases
• Tuberculosis
• Diverticular disease (diverticulitis)
• Crohn’s disease or inflammatory bowel disease
• Radiation treatment or cancer in the pelvic area

HOW IS ANAL FISTULA DIAGNOSED?

Diagnosing anal fistula will begin with a medical exam. However, not all anal fistula are visible. For this reason, your doctor may order tests such as an ultrasound or an MRI to help diagnose the problem.

At Loma Linda University Health, diagnosis of an anal fistula is handled with utmost professionalism. We treat you with dignity and respect at all times.

HOW IS ANAL FISTULA TREATED?

Currently, there are no medications available for this condition. Surgery is almost always necessary to cure an anal fistula. Possible surgery options include:

• A thin piece of rubber or suture) placed through the entire fistula tract referred to as a draining seton
• Surgically opening a fistula to allow it to heal, referred to as fistulotomy 
• A portion of the rectal wall may be used to seal the opening in the case of more complex fistulas, referred to as advancement flap repair  
• A means of gently and slowly cutting through the tunnel to allow the tissue to heal, referred to as a Seton insertion, or cutting seton
• The fistula tract may be disconnected, allowing both internal and external openings to collapse and heal, referred to as Ligation of Intersphincteric Fistula Tract (LIFT)
• A procedure where the internal opening of the fistula is covered over by healthy, native tissue, referred to as an endoanal advancement flap

At Loma Linda University Health, we believe in treating the whole patient. For this reason, we may also make lifestyle and dietary recommendations to colorectal patients.

WHAT ARE THE COMPLICATIONS OF ANAL FISTULA?

Complications of anal fistula can include:

• Infections
• Abscesses
• Pain and irritation
• Emotional distress
• Incontinence

WHO IS AT RISK FOR ANAL FISTULA?

Those who are most at risk of developing anal fistula are:

• Women who have given birth
• Those who have had radiation treatments or cancer in the pelvic area
• Those who have had surgery in the pelvic area
• Those who live with Crohn's disease or inflammatory bowel disease
• Those who have had an anal abscess
• Those with sexually transmitted diseases  
• Those with tuberculosis

NEXT STEPS 

Seek medical intervention.Being proactive is important, and it starts with a medical evaluation. If you believe you may have anal fistula, request an evaluation at Loma Linda University Health. Contact your care provider or schedule the appointment through MyChart.