An anal fistula is an infected tract that is formed between the skin and the muscular opening at the end of the anus.

Most anal fistulas arise from infections in the anal gland. This infection causes abscess that drains continuously through the skin next to the anus. An anal fistula is usually treated through surgery.

About the Surgery

1. Overview: It is a minimally invasive procedure. This procedure involves emission of laser fiber with a small laser beam to seal the fistula.

2. Snapshots:

  • Procedure Type: LASER Surgery
  • Anesthesia: Spinal Block/General Anesthesia/Local Anesthesia
  • Hospitalization: No hospitalization required (Day care)
  • Procedure time: 30 minutes - 1 hour
  • Recovery Time: 2-3 days

3. Post-Surgical Care

  • Regularly change the dressing of the wound
  • Eating fiber-rich diet and drinking plenty of fluids
  • Use warm water and cotton to wash the skin and keep the area dry and clean
  • Do not have sexual intercourse for at least 10 days
  • Do gentle exercise and avoid lifting weights. 

4. Advantages of this Procedure: Cost-effective procedure, no risk of infection, no cuts/incisions, patient can resume normal activities within a day and recover quickly. The laser treatment does no harm to the skin, reproductive system, internal organs, or genitals of the patient.

Fistula is formed because of an abscess. If you have an anal abscess, there are good chances that you are prone to developing an anal fistula too.

Fistulas are formed due to certain conditions of the lower digestive or anal track like -

  • Colitis

  • Chronic diarrhea

  • Crohn's disease

  • Radiation treatment for rectal cancer

  • Tuberculosis

  • Sexually transmitted diseases

  • Ulcerative colitis

If you have a history of an abscess or symptoms of fistula, you should not miss these signs and contact your doctor immediately.

  • Complications could be due to recurring fistula.

  • An inability to control bowel movements (faecal incontinence)

  • Fever

  • Chills

  • Swelling

  • Redness

  • Discharge

  • Bleeding

  • Discharge

  • Constipation

  • Trouble in controlling bowel movements

If you are dealing with a fistula or recovering from a fistula treatment you can undertake the following practices for some comfort.

  • Soaking the area of the fistula in a warm bath 3 or 4 times a day.

  • Avoiding strenuous activities.

  • Eating fiber rich diet and drinking plenty of fluids.

  • Using a laxative as recommended by your doctor.

Anal fistulas need to be treated by a specialist dealing in the colon and rectal diseases. 

The specialist will have a check on your medical history as well as the probe the sight of the fistula and recommend further diagnosis -

  • Fistula probe

In this way of diagnosis, a long thin probe is guided through the outer opening. A special dye might be injected just to check where the fistula opens on the inside.

  • Anoscope

This scope guides through the anal tract. It is a tubular device and inserted a few inches into the anus to diagnose any anal anomalies.

  • Imaging studies

Fistulas might appear superficial. The imaging studies recommended for diagnosing fistulas could be an ultrasound or an MRI scanning for understanding how deep-set the fistula is.

Fistulas are usually treated through surgeries for faster and better recovery.

There are different types of treatment a surgeon might opt for depending on the patient's specific condition.

  • Fistulotomy

The fistulotomy opens the fistula inside out and results in better and faster healing. The surgeon would cut the opening, scrape and clean the infected area and then flatten and suture it back. 

Fistulotomy usually involves cutting the sphincter muscle. Fistulotomy might be a complicated process when the entire channel needs to be removed, in that case, the process might be done in two stages.

Fistulotomy being an outpatient procedure the patient can go home the same day.

  • Filling the fistula (Collagen plus or Fibrin Glue)

This is a relatively new technique.

This procedure uses a special glue or plug to close the inner opening of the fistula. The surgeon clears and cleans the channel and closes the input of the fistula with sutures. 

A special fibrous protein called fibrin is then inserted in the fistulas through the external opening of the fistula. The anal tract is then closed shut with a protein collagen plug.

  • Reconstructive surgery

Reconstruction surgery is usually done in stages and opted in some cases recommended by the surgeon. The reconstruction surgery is known as Ligation of the Intersphincteric Fistula Tract (LIFT).

This procedure is used to cure deep-seated fistulas. The procedure is done in stages several weeks apart.

  • Seton placement. 

The seton placement procedure uses a rubber band (seton), silk or latex string into the fistula to help drain out the infection. 

For complex fistula, the doctor would recommend invasive procedures like-

   Colostomy

Under this procedure, a temporary opening is made in the abdomen to divert all the waste and drain into a collection bag. This allows time to the anal area to heal.

  • Muscle Flap

This procedure is out for complex anal fistulas, where healthy muscles from thigh, buttock or labia are used to fill the fistula channel.

Anal fistulas are more common in people with Crohn's disease. For patients with both Crohn's disease and a fistula, medical therapy is usually tried before surgery.

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    • Expert in Spine Injury

    • Expert in Arthiritis Management

    • Expert in Spinal Diseases

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Dr Vinod Rajkumar
Dr Vinod Rajkumar

General Surgeon

MBBS , MS (GS)

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    • 14+ years of experience in perfomring general surgical procedures

    • Expert Laparoscopic Surgeon

    • Expert in Bariatric Surgery

    • Expert in Upper GI Endoscopy

    • Expert in HPB oncology

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Dr Rajesh B M
Dr Rajesh B M

General Surgeon

MBBS, MS (GEN SURGERY)

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Dr Sonam Manohar Devlekar
Dr Sonam Manohar Devlekar

General Surgery, Laparoscopic Surgery

MBBS, MS General Surgery, DNB General Surgery

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    • 31+ years of experience as a Laparoscopic, General Surgeon

    • Expert in Minimally Invasive Surgery

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Dr Basant K Dalmia
Dr Basant K Dalmia

General Surgery

MBBS, MS - General Surgery

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Dr Rajath Saxena
Dr Rajath Saxena

General Surgeon

MBBS, MS - General Surgery, MRCS (UK) Thoracic (Chest) Surgeon, General Surgeon

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Dr Rakesh Rai A
Dr Rakesh Rai A

General & Laparoscopic Surgeon

MS (General Surgery)

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Dr Kumar S S
Dr Kumar S S

General Surgeon

MBBS, MS(general Surgery)

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Dr Srinivas B Kulkarni
Dr Srinivas B Kulkarni

General Surgeon

MBBS, DNB (GENERAL SURGERY), FMAS

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FAQs and Related Articles

Causes of Anal Fistula are: 1. When an anal gland had developed a pus-filled infection (abscess) 2. Some may happen with certain conditions such as Crohn's disease 3. Some people may get fistula after radiation therapy of cancer 4. Untreated anal fissures might lead to anal fistula

Fistulas can be life-threatening in the sense that the untreated fistulas can cause serious complications because of bacterial infection leading to low blood pressure, organ damage and even death. A fistula problem should therefore be addressed in time.

No, anal fistula needs medical attention since it does not heal on its own. If you ignore anal fistula then it can lead to further complications.
If you ignore fistula then it may lead to further complications such as faecal incontinence, sepsis, perforation and peritonitis.

Wash is a treatment of the anal fissures and can be followed as a regimen to do a warm water sitz bath after bowel movement. (A sitz bath can relieve pain, itching and other discomfort in the genital areas).

Fistulas can develop due to radiation therapy. However, fistulas do not necessarily lead to cancer.

Once treated and healed properly, there are rare chances that the fistula will reoccur. However, it will only recur if you deviate from the medications, dietary restrictions and activities prescribed by the doctor.

Medications can only give you temporary relief, the only cure for fistula is surgery.

The ideal person for fistula treatment is a proctologist, who is also called a colorectal or a colon and rectal surgeon. He specializes in diagnosing and treating lower gastrointestinal tract (colon, rectum and anus) problems.

MRI Fistulogram and/or colonoscopy.

It can be life-threatening when left untreated, leading to low blood pressure, organ damage and even death.

You’ll need to consult your doctor in case you experience pain, nausea, fever, inflammation, vomiting, lack of bowel control, swelling in the affected area, redness in the anal region or swelling of lymph nodes in the groin.

Delaying can aggravate the condition, causing bleeding and the need for an emergency surgery.

We would require a copy of your prescription and the MRI / colonoscopy reports, we will share this with our doctor and provide you with an online consultation post which we can do the surgery the same day.

When you have fever, chills, redness, swelling, discharge, bleeding, constipation and trouble controlling bowel movements and when you observe blood in stool, pain when you sit, irritation/itching sensation near the anal canal.

Fistulas do not necessarily cause cancer.

No, fistulas need medical attention and do not heal on their own.

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