Fistula in Ano

An infected tunnel between the skin and the anus. An anal fistula is an infected tunnel between the skin and the anus, the muscular opening at the end of the digestive tract. Most anal fistulas are the result of an infection in an anal gland that spreads to the skin. Symptoms include pain, swelling and discharge of blood or pus from the anus. Surgery is usually required to treat anal fistula.

Causes

The leading causes of an anal fistula are clogged anal glands and anal abscesses. Other, much less common, conditions that can cause an anal fistula include: Crohn's disease (an inflammatory disease of the intestine) Radiation (treatment for cancer)

Diagnosis

Our doctor diagnose an anal fistula by examining the area around the anus. We will look for an opening (the fistula tract) on the skin. The doctor will then try to determine how deep the tract is, and the direction in which it is going. In many cases, there will be drainage from the external opening.
Some fistulas may not be visible on the skin's surface. In this case, your physician may need to perform additional tests:

An anoscopy is a procedure in which a special instrument is used to see inside your anus and rectum.

We also order an ultrasound or MRI of the anal area to get a better view of the fistula tract.

Sometimes we will need to examine you in the operating room (called exam under anesthesia) to diagnose the fistula

Treatments

There are several surgical options to treat fistulas, including:

A medical plug to close the fistula and allow it to heal

A thin surgical cord, called a seton, placed into the fistula to help drain any infection and allow it to heal

Opening up the fistula with an incision along its length to allow it to heal

Medical glue to close the fistula

While some fistulas can be treated with antibiotics and other medication, fistula removal surgery may be necessary if the infection doesn’t respond to medication or if the fistula is severe enough to require emergency surgery.