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Last Updated: Jan 10, 2023
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Anal Fistula - What Causes It?

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Dr. S K Singh, Sushruta Ano Rectal Institute Piles And Fistula TreatmentGeneral Surgeon • 37 Years Exp.M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
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Anal Fistula - What Causes It? 
An anal fistula refers to a small infected tunnel connecting the anus to the outer skin. Your body eliminates solid waste products or feces through the anus. When any of the glands inside the anus becomes infected or blocked, an abscess may form, which in turn results in formation of anal fistula. In about 50% of the cases, abscesses develop into fistulae. What are the causes for anal fistula? Anal fistulae occur primarily due to the formation of an abscess or infection in the anus. If the abscess does not heal completely after the pus has been drained away, a fistula can develop. 

Other factors responsible for the occurrence of anal fistulae are- 

  1. Crohn’s disease- a chronic condition where the digestive system becomes inflamed. 
  2. Diverticulitis- an inflammation of the small pouches that develop along the intestinal walls. 
  3. Hidradenitis suppurativa- a chronic painful skin condition which causes scarring and abscesses on the skin. Apart from these, people with HIV or infected with Tuberculosis disease also develop anal fistulae. If you’ve had a surgery around the anus, then post-surgery complications may lead to infection or abscess on the skin. 

What are the symptoms to watch out for? 
The commonly observed signs and symptoms of anal fistulae include- 

  1. Irritation or discomfort on the skin around the anus 
  2. Occasional throbbing pain, especially while seated, moving around or having a bowel movement 
  3. Nodular swelling around anal region 
  4. Intermittent Discharge of blood or pus from an opening near anal orifice. 

How does Ayurveda treat anal fistulae? 
Ayurveda recommends Ksharsutra treatment for complete healing of Anal Fistula.

In this procedure; Ksharsutra – a medicated thread is placed in Fistula tract. Medicine released from Ksharsutra debrides the fistula tract and induces healing. This medicine remains active for about 5-7 days so this thread needs to be changed with a new thread at weekly interval. No. of Ksharsutra changes required for complete healing of Fistula depends on length depth and branching pattern of fistula. It has been observed that Fistula heals at the rate of 0.5 to 1 cm per Ksharsutra changes so for a fistula tract of 3 cm length about 4-5 weekly thread changes are necessary for complete healing. Clinical trials conducted by Indian Council of Medical Research at AIIMS New Delhi have proved that Ksharsutra treatment is more convenient and more effective than Surgery in case of Anal Fistula. In this way Ksharsutra is the best way to treat Anal Fistula without Surgery. In case you have a concern or query you can always consult an expert & get answers to your questions!

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