5 Signs of an Anal Fistula (and What to Do Next)

Your body is a self-contained system with a set of entries, exits, and passageways that it regulates closely. When something breaches this closed system and creates a passageway and exit that shouldn’t exist, problems can arise. This is exactly the case with an anal fistula.

As colorectal surgical experts, the team here at Fairfax Colon & Rectal Surgery routinely helps patients who’ve developed anal fistulas, which affect about 8.6 people per 100,000, with men outpacing women by two to one.

In the following, we review how these abnormal passageways form, a few of the more common signs of anal fistulas, and how we go about treating this uncommon rectal issue.

The making of anal fistula

As we mentioned, an anal fistula is an abnormal passageway that shouldn’t exist. More specifically, this passageway goes from the inside of your anus, usually from one of your anal glands, to the outside of your skin on your buttocks.

In most cases, a fistula forms on the heels of an anal abscess — people with anal abscesses have a 50% chance of developing a fistula. This occurs when the drainage from the abscess in your anal glands creates a tunnel, leaving you with a new passageway that can lead to problems.

Outside of anal abscesses, people with inflammatory bowel diseases, such as Crohn’s, are also vulnerable to anal fistulas.

Side effects of an anal fistula

The potential side effects of an anal fistula are hard to ignore and include:

Pain

You might feel pain around your anus, especially when you add pressure, such as when you have a bowel movement. The area around your anus may also be tender and sensitive to the touch.

Discharge from the fistula opening

The new tunnel may ooze pus from the abscess, as well as blood and bits of stool, all of which are foul-smelling.

Inflammation and redness

Most people develop inflammation and redness around the opening of the fistula when it’s active.

Another abscess

If the opening of the fistula heals over and cuts off drainage, another abscess can form in your anal glands.

Fever and chills

If an infection takes hold again, you can experience fever and chills, so you should seek our help immediately.

Getting relief from your anal fistula

Once an anal fistula forms, it doesn’t go away on its own. Even if the opening near your anus heals over, the passageway is still there, and it can lead to problems (infections) down the road.

The best way to address an anal fistula is surgically, which is our area of expertise. The good news is that most anal fistulas are simple fistulas that don’t involve a lot of sphincter muscle, and nor do they have offshoots. So, in 95% of cases, we correct the issue with a fistulotomy, an outpatient procedure in which we cut the top of the fistula to encourage it to heal from the inside out.

If your anal fistula involves more sphincter muscle, correction may not be as simple, and we may have to perform the surgery in two steps so that we can preserve your control over your bowel movements.

We also have other techniques to surgically correct anal fistulas, such as Seton drains and filling the fistula to close it off, and we will work with you to find the best approach.

As you can see, we’ve got you well covered when it comes to anal fistulas and anal abscesses. For expert diagnosis and treatment of these conditions, please contact one of our offices in Fairfax, Fair Oaks, Alexandria, Gainesville, Woodbridge, or Lansdowne, Virginia, to schedule an appointment.