What is an anal fistula?
An anal fistula is an abnormal tunnel between the anal canal
and the outer skin of the anus. The anus is the opening of
the rectum where bowel movements (BMs) leave the body.
How does it occur?
An anal fistula usually results from an infection that forms
in the tissue lining the anal canal. The infection may be
caused by the bacteria that normally exist in the rectum.
Sometimes an anal fistula may occur as a result of:
- a healed sore in the rectal area
- ulcerative colitis, a disease that damages the colon and
rectum
- diverticulitis, inflammation of small, harmless pouches
in the wall of the intestines
- Crohn's disease, a chronic inflammation of the intestines
- tuberculosis of the bowel
- gonorrhea in the rectum
- cancer of the large intestine.
What are the symptoms?
Symptoms of anal fistula may include:
- itching
- discharge of watery pus
- irritation of the skin around the anus
- pain
- leakage of stool between bowel movements.
How is it diagnosed?
Your health provider will review your symptoms and examine
you. You may have one or more of the following procedures:
- anoscopy, a procedure in which your provider inserts an
instrument with a light into the rectum to look at the
anus and lower part of the rectum
- sigmoidoscopy, a procedure in which your health care
provider uses a flexible or rigid scope to inspect the
lower part of the intestine for inflammation or disease
- a biopsy to check for inflammation or cancer
- lower gastrointestinal (GI) series, a procedure that uses
a special fluid to show the intestines better on x-ray.
How is it treated?
The procedure used to treat an anal fistula is called a
fistulotomy. Your health care provider opens the infected
area and allows the fistula to drain. Stitches usually
are not needed.
Small or shallow fistulas may be treated in your health care
provider's office after you are given a local anesthetic to
numb the area. Larger fistulas must be treated surgically
under regional or general anesthesia. If the fistula is
complex and goes through both anal sphincter muscles, more
than one procedure may be necessary.
After a fistulotomy, your health care provider will
prescribe stool softeners and rest. In addition, your
provider may prescribe antibiotics to fight any infection.
How long will the effects last?
An anal fistula usually lasts until it is surgically
removed.
How can I take care of myself?
Follow your health care provider's instructions.
Caring for yourself at home after surgery may include:
- using stool softeners
- adding fiber to your diet
- drinking plenty of water
- taking warm baths
- using clean, moist pads to wipe the area around the anus
to remove irritating particles and fluid from the fistula
- using special skin creams to soothe irritated tissue.
How can I help prevent an anal fistula?
There is no known way to prevent an anal fistula. However,
there are ways to try to keep your lower GI tract healthy.
- Eat food high in fiber.
- Drink plenty of water.


Disclaimer: This content is reviewed periodically and is subject to
change as new health information becomes available. The
information provided is intended to be informative and educational and is not a
replacement for professional medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
HIA File DIG4002F.HTM Release 9.0/2006. Copyright © 2006 McKesson Corporation and/or one of its subdiaries. All Rights Reserved.
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