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Last Updated: Oct 07, 2021
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Anal Fistula: Treatment, Procedure, Cost and Side Effects

About Symptoms Treatment Complications Eligibility Ineligibility Side Effects Post-treatment Guidelines Recovery Price Results Alternatives

What is the treatment?

An anal fistula refers to an infected tunnel that develops right between the muscular opening at the end of the digestive tract (called the anus) and the skin. Anal fistulas are caused by an infection that is present in the anal gland. When the infection stays for a while, it ends up leading to an abscess that is either drained naturally by the body or through a surgery through the skin present next to the anus. As a result the fistula develops between the skin and the infected gland. It can only be treated by surgery.

There are many different treatment options for an anal fistula however all of them require some amount of surgery. A fistulotomy is one such option. You can also have an advancement rectal flap to correct the fistula. Seton replacements are also commonly suggested treatments. You can also have a fibrin glue or collagen plug put in to close the fistula. Lastly, your doctor may also suggest ligation of the intersphincteric fistula tract (LIFT) in order to correct this condition.

What does an Anal Fistula look like?

Anal Fistula which usually develops from an infected anal gland, have an appearance similar to an open boil on skin. It is actually a tunnel-like pathway that is abnormal as well as infected in its form. In some cases, the Anal Fistula forms its way starting from an internal gland reaching outside to the skin around the anus.

Is a fistula permanent or temporary?

Fistula is a type of vascular access site which is formed when an artery is joined with a vein beneath the skin in the arm. It may be temporary or permanent, however, the A-V fistula can be considered as permanent as it can be used for several years in case of hemodialysis.

How is the treatment done?

The first step to beginning the treatment is to find out the exact path of the fistula. Without knowing exactly where it is or how big it is, the doctors cannot suggest the most effective treatment plan for you. Thus, an MRI will be conducted for them to find out. Sometimes, an endoscopic ultrasound may needed to form a clearer picture. There is also a specific procedure known as a fistulography, which is essentially a high contrast X-Ray of the fistula. Other than these, a fistula probe, anoscope, flexible sigmoidoscopy, or an injected dye solution are also viable methods to find out more about your fistula.

Based on what the doctors find, your treatment plan will be decided. If you are going through a fistolotomy, the surgeons will cut the internal opening of the fistula and scrap the entire lining to get the infection out before closing the channel with stitches. In an advancement rectal flap, the surgeon will first close the internal opening of the fistula and then cover it with a flap taken from the rectal wall. If the treatment suggested to you is a seton placement, then the surgeon will use a string made of latex or silk to drain out the infection. If a fibrin glue or collagen plug is being used, then the internal opening of the fistula will first be closed before the glue or plug is injected into the fistula to close the tunnel. If a LIFT procedure is being used, there are two steps to expect. The first is that the surgeon will start with a seton procedure to widen the fistula over a period of time. Then the fistula will be closed.

Can a fistula heal on its own?

The Anal Fistula needs to undergo adequate treatment since it does not get healed itself. Surgery is the preferred method for treating the Anal Fistula which needs to be done carefully. It can be done either by opening the fistula or removing the tract inside. In case fistula is left untreated or delayed treatment, complications like cancer may develop.

How serious is Anal Fistula?

An Anal Fistula is a serious condition accompanied by frequent pain and discomfort. Apart from this, it is also associated with the development of abscess formation, painful discharge, and bowel movements. Bacterial infections of the skin may also occur which can lead to severe complications like sepsis, which may further cause organ damage, low blood pressure, or death.

Who is eligible for the treatment? (When is the treatment done?)

If you have developed an anal fistula, then you are eligible to seek out treatment for it.

Who is not eligible for the treatment?

If you are allergic to silk or latex, a seton placement and a LIFT procedure may be out of the question for you. Furthermore, if you do not have an anal fistula, then you cannot seek treatment for it.

Are there any side effects?

Since all the procedures to treat anal fistulas are surgical, there are a few common side effects to expect. With most surgeries, bruising, swelling and pain is common. Anal incontinence is also one of the side effects of getting surgery in the anus or rectal walls. Constipation, an inability to walk, and disorientation due to pain are also some side effects that one can experience. Some people end up being allergic or latex or silk and therefore can develop complications if they have opted for a seton placement or a LIFT.

What are the post-treatment guidelines?

One of the major post treatment guidelines is a strict control over the diet as it is imperative that the digestive tract functions normally in the days after surgery. This is because the aim is to allow the anus and rectal walls to heal in their natural state, otherwise it can cause problems with excretion later on. As a result, the patient will have to maintain a diet that is high in fibre and stay away from spicy food for a while. For often than not, if everything is going smoothly, patients are discharged after their first successful bowel movements and are allowed to recover in the comfort of their homes.

What should you not do with a fistula?

There are some precautions that need to be taken while carrying a fistula. Some of those precautions include the following:

  • Measurement of blood pressure should be avoided from the arm with a fistula.
  • Blood should not be taken from the arm for blood tests.
  • Needles, infusion, or drips should not be used in that arm.
  • Sleeping on that arm must be avoided.
  • Tight or fitting clothes must not be worn.

How long does it take to recover?

Patients are normally discharged after having their first bowel movement, which normally occurs within one or two days. However, it takes close to two weeks to recover fully from the surgery and its effects. The internal stitches within the body also dissolve around this time.

How long does a fistula last?

Fistula, which is used as a vascular access site in the case of hemodialysis, is made by joining an artery with a vein beneath the skin in the arm. It is a type of A-V fistula that usually takes a time period of about three to four months to get healed completely to become ready to be used for hemodialysis.

What is the price of the treatment in India?

The surgical procedure can cost anywhere between Rs 98,000 – Rs. 3,00,000, depending on the hospital and city that you get the procedure done from.

Are the results of the treatment permanent?

The results of the treatment are permanent.

What are the alternatives to the treatment?

There are no home remedies or alternatives to the treatment. It is important to get the fistula corrected as soon as possible as further infections can lead to complications.

Summary: An Anal Fistula develops from an infected anal gland having an appearance similar to an open boil on skin. It is a serious condition that is accompanied by frequent pain and discomfort along with the development of abscess formation, painful discharge, and bowel movements. The preferred method for treating the Anal Fistula is Surgery. It can be done either by opening the fistula or removing the tract inside. In case fistula is left untreated or delayed treatment, complications like cancer may develop.

Popular Questions & Answers

I hv a fissure problem for 7 years I get relief if I tke daflon 1000 tablets. Bt problem starts again if I get hard stool. N I hv to depend on tablets.

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery
General Surgeon, Hyderabad
Take high fibre diet and plenty of fluids so that you don’t have hard stools. Repeated episodes of fissure may require surgical treatment. please visit to the clinic to get an examination done.

I have developed piles or haemorrhoids after taking antibiotics or flagyl 500 three times a day for a few days. My stool is very hard and causing pain during bowel movement. How and why this happened? How can I treat this condition?

M.S GENERAL SURGERY, Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.), Medicine
General Surgeon, Hooghly
Hello. This pain during defecation is likely due to anal fissure. For the time being, avoid hot, spicy and non veg food. Drink plenty of water. The treatment involves using laxative syrup, using local anti-inflammatory cream, pain relievers and si...

I am feeding mother. My baby was born on april 11. I have severe fissures problem. When I was conceive my doctor suggest the following tablets. Phexin 500 mg. Chymobest.rablet 20 mg. I searched in google phexin 500 mg tablet affect the newly born infants. this affect the infant or not. What is the alternate solution of my fissures problem.

M.S GENERAL SURGERY, Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.), Medicine
General Surgeon, Hooghly
Hello lybrate-user. Firstly, my best wishes for you and your child. May you be blessed always. For anal fissure, the treatment mostly involves using laxative syrup (duphalac), local ointment/ cream (fidonal/ anometrogyl), sitz bath and analgesics ...

My mother and i'm suffering from hard stools and hemorrhoids and difficulty in passing stool and feeling pain in anus area what is the treatment for it. Can I take metrogyl tablet for it or not please help.

BHMS
Homeopathy Doctor, Noida
1. Take home cooked, fresh light food. Take a lot of green vegetables n fruit. 2. Increasing the fibre in your diet is known to be as effective as injections for preventing further problems 3. Increasing your fluid intake which can help prevent fu...

Hello doctor i, m 23 years old girl I have a problem of anal fissure and i, m using anobliss cream on my anal opening but there is a one cut that is not healing properly since two months so can I use this cream for healing? Or need any other precaution for healing that cut is decreased somehow but not closing please help me.

MBBS, MS - General Surgery
General Surgeon, Hyderabad
Sitz bath with like warm water for 20 mts ano bliss ointment high fibre diet plenty of oral fluids avoid spicy and heat causing food this is your treatment but once consult general surgeon to check for healing and any need for surgery

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