Anal Fistula

Anal fistula refers to small passage that develops between the skin near the anus and the end of the bowel. It can also be described as an infected cavity full of pus close to the rectum or anus. It often follows an infection that never healed in the right manner.

In fact, 90% of all anal fistula cases are a result of an acute infection in the internal glands of the anus. It occurs in approximately 50% of patients with abscesses.

The prevalence of anal fistula is estimated to be 8.6 cases in 100,000 population. The Prevalence is higher among men at 12.6 in 100,000 men compared to 5.6 in 100,000 women.


Anal fistula is among diseases with very unpleasant symptoms. They include:

  • Discomfort and skin irritation around the anus
  • Passing blood or pus when you go for a long call
  • Smelly discharge from near the anus
  • A throbbing and constant pain that may get worse when you move around, sit down, or cough or have a bowel movement
  • Redness and swelling around the anus accompanied by fever if you also have an abscess
  • Difficult controlling bowel movements


Anal fistula is mostly caused by anal abscess (infection in anal cavity). However, in few cases, anal fistula may be caused by:

  • Crohn’s disease: a prolonged condition in which the digestive system is inflamed
  • Diverticulitis: Infection of the small pouches that may easily stick out of the side of the colon
  • Infection with HIV or tuberculosis (TB)
  • Hidradenitis suppurativa: A prolonged skin condition that causes scarring and abscesses
  • A complication resulting from surgery near the anus

When to See a Doctor

Visit or consult a doctor if you experience symptoms of an anal fistula. Do not wait for the condition to get worse because it might complicate the treatment process.

Once at the doctor, he or she will ask you a few questions to substantiate the signs and symptoms before conducting further tests to diagnose the condition.


  • As mentioned, the first process will be to be asked a few questions concerning past medical history and anorectal symptoms.
  • The second step will be a physical examination where the doctor will check the area around the anus to see whether there is pus, redness, rushes, and/or swelling.
  • The third process would be digital rectal exam where the doctor will likely to see stool or blood, heaped up tissue at the external opening, and pus from the external opening.
  • Further tests may include ultrasound or MRI, X-rays, and colonoscopy

Once the doctor determines the condition is anal fistula, he or she will proceed to treatment.


Just like other types of fistula, the main treatment for anal fistula is surgery. The doctor will schedule you for a surgery immediately he or she diagnoses anal fistula.

 This is because there is no medication to fix anal fistula. The surgery options include:

  • Seton procedures: It is where a surgical threat known as a seton is put in the fistula and left for many weeks to help it heal before a further procedure is conducted to treat it
  • Fistulotomy: This is the main procedure that involves cutting open the entire length of the fistula to make it heal into a flat scar
  • Other Techniques: They include blocking the fistula with a special plug, filling it with special glue, or covering it with a flap of tissue

All these procedures have their benefits and risks. Make sure to discuss them with the surgeon before the treatment process commence.

For more information on anal fistula, conduct a doctor or a hospital near you through the Uzima Health App available on Google Play.