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Anal fistula is an abnormal tract between internal anal canal and perianal skin. Usually follows abscess drainage. Causes purulent drainage, pain, and recurrent symptoms. Common in Crohn's disease. Requires surgical treatment for cure.
Imaging: MRI or endorectal ultrasound for fistula anatomy and classification.
For straightforward, low fistulas crossing minimal sphincter. Divides fistula tract. High healing rates with minimal incontinence risk.
For high or multiple tract fistulas, Dr. Ashok Kumar uses advanced sphincter-preserving techniques including flap procedures and staged management.
Hospital stay 1-2 days. Healing 6-12 weeks. Success rates 80-90% for simple fistulas. Regular follow-up for healing and infection. Most patients achieve complete cure without incontinence.
An anal fistula is a small tunnel that connects the inside of the anal canal to the skin near the anus. Most fistulas develop after an anal abscess, which is a collection of pus that forms when one of the small glands inside the anus becomes blocked and infected. When the abscess bursts or is drained, a track can remain and keep discharging.
Less common causes include Crohn's disease, tuberculosis, previous surgery, radiation treatment and injury. In India, tuberculosis is an important cause to consider when a fistula keeps coming back.
Fistulas are described by how they pass through the anal sphincter muscles that control bowel movements. A low (simple) fistula crosses little or no sphincter muscle. A high or complex fistula crosses a larger part of the muscle, has several branches or openings, or is linked with Crohn's disease. The type matters because it decides which operation is safest for bowel control.
Your surgeon will examine the area and may gently probe the external opening. For recurrent or complex fistulas, an MRI scan of the pelvis (fistulogram MRI) maps the exact course of the tunnel and any hidden branches or abscesses. Endoanal ultrasound is another option. Tests for tuberculosis or Crohn's disease may be advised when the history suggests them.
An anal fistula does not heal with medicines alone in most cases, although antibiotics may be used to control infection before surgery. Surgery aims to remove or close the track while protecting the sphincter muscles.
Most patients go home the same day or the next day. You will be advised on sitz baths, wound care, pain relief and keeping stools soft. Healing of the wound can take a few weeks, and regular follow-up visits help make sure the track heals completely.
It is uncommon. Most fistulas need a surgical procedure, although the timing and type depend on how complex the track is.
Recurrence is more likely with complex or branching tracks, missed secondary tracks, or an untreated underlying cause such as Crohn's disease or tuberculosis. Careful imaging before surgery reduces this risk.
It is done under anaesthesia, and pain afterwards is usually controlled with tablets and warm sitz baths. Most people return to desk work within one to two weeks.
Book a consultation: call 0522-666-4444 or use the request call back form on this page. In an emergency, come straight to the 24/7 emergency department at Charak Hospital, Hardoi Road, Dubagga, Lucknow.