Anal Fistula Treatment

[fis-tu-lar] An anal fistula is an abnormal communication (connection) between the anal canal and the skin of the anal area.

What is a Fistula?

Often, an anal fistula arises after an infection in one of the anal glands, such as a perianal abscess. Anal fistulas also occur in Crohn’s Disease.

Typical symptoms of an anal fistula include recurrent painful swelling on the perianal skin (the skin near the anus). It’s also common to notice a pus-like discharge.

Treatments

Anal fistula treatment depends on the results of an examination. When you are referred to a colorectal surgeon for anal fistula treatment, we examine how much the sphincter muscle is involved in the fistula track. To do this, we conduct a thorough examination of the anus under anaesthetic. Sometimes, an ultrasound or MRI can help.

While you are receiving anal fistula treatment, it’s important to keep your bowel regular and soft. Avoid straining in the bathroom.

Below, we describe some of the common procedures for treating anal fistulas. Your colorectal surgeon will talk with you about the exact procedure you need. Sometimes, several steps are involved.

And, of course, you’re always welcome to ask us any questions about your treatment procedure. We’re here to help you feel informed and comfortable about your treatment.

Laying Open

If there is no muscle involved, or only a very little amount, then the anal fistula track can be cut or ‘laid open’. This results in an open wound rather than the tunnel that was there before. This wound will heal over time, from the bottom up.

Seton

If the anatomy of the anal fistula is not clear, or if there is an active infection, a seton drain may need to be placed to treat the fistula.

A seton is a piece of rubber that is placed through the fistula track (similar to the way a nose ring is placed). It is a loose rubber band that allows any infection and inflammation to settle. This helps the anatomy to become clear and the tissues to become soft and suitable for surgery. You can typically bathe and toilet in the normal way after this procedure.

Lift

This procedure involves identifying the anal fistula in between the sphincter muscles. It is then tied off, and the anal canal is repaired.

There are other anal fistula treatment options, too, depending on your specific condition. For more information, it’s best to speak with your colorectal surgeon about your particular case.

With any treatment for anal fistula, it’s normal to have some anal pain and discomfort afterwards. To help manage this, you should attempt to keep your stools soft. Avoid prolonged sitting on the toilet and straining.

Wound care involves a shower or bath twice daily. You will also be advised to wear a dry pad in your underwear.

You can use painkillers after your anal fistula treatment, but be mindful to also take stool softeners if you use a painkiller that’s stronger than paracetamol or Nurofen.

Things to Watch Out For

If you’ve undergone this procedure, and you notice any of these symptoms, you should contact your doctor for further treatment

  • Excessive Bleeding

    With clots that does not settle over two or three days

  • High Fever, Sweat, Rigors or Shakes

    High fevers/ sweats/ rigors or shakes

  • Excessive Pain

    Excessive pain not relieved by regular pain relief

If you have any concerns or questions, or if you experience any of the above symptoms, please contact Coast Colorectal on (07) 5598 0825 during business hours (Monday to Friday). If it’s outside these hours, you can contact your GP or hospital instead.