What department should I see for anal fistula?

Written by Yang Dong

Colorectal Surgery Department

Updated on September 08, 2024

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Anal fistula is caused by infection of the anal sinuses and glands. It manifests as hard lumps or cord-like objects around the anus, and may involve recurrent swelling, pain, and discharge of pus. In such cases, it is necessary to consult a colorectal surgeon. Generally, if diagnosed with an anal fistula, surgical treatment is required, as conservative treatment usually does not result in a cure.

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Written by Yang Dong

Colorectal Surgery Department

28sec

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What are the symptoms of an anal fistula?

Anal fistula is one of the common diseases in proctology. The most typical symptom of anal fistula is recurrent anal induration, accompanied by swelling, pain, and pus discharge, often with a ruptured external opening. During the quiescent phase, a hard cord can be felt leading from the ruptured external opening to the inside of the anus; during the acute inflammatory phase or abscess phase, pressing may cause pus to ooze from the ruptured opening.

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Written by Chen Tian Jing

Colorectal Surgery

1min 1sec

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Anal fistulas secondary to which disease?

An anal fistula generally originates from a perianal abscess, which is an infection focus formed near the anal sinuses in the local area of the anus. During its onset, there is obvious local redness, swelling, heat, and pain accompanied by the formation of a pus cavity containing pus. As the condition of the perianal abscess worsens, the local pus cavity will rupture and discharge pus, thus forming an anal fistula. After the rupture of a perianal abscess, its external opening cannot heal by itself, and there will be intermittent recurring discharge of pus. Therefore, it is necessary to carry out surgical treatment as soon as possible after the formation of an anal fistula, to prevent the enlargement of the local pus cavity or thickening of the fistula wall, which complicates later surgery and treatment and significantly impacts the patient's normal life.

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Written by Chen Tian Jing

Colorectal Surgery

1min 7sec

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How to deal with a ruptured anal fistula?

The clinical symptoms of anal fistula mainly include intermittent discharge of pus from the external opening near the anus, or occasional acute attacks that cause redness, swelling, heat, and pain around the external opening of the anus. If the external opening of the anal fistula breaks and discharges pus, or is accompanied by pain, it is considered an acute phase of the anal fistula. The primary method of management and treatment is surgery, with the main surgical approach being fistulotomy and seton placement. To locally alleviate the inflammatory symptoms of the external opening of the anal fistula, anti-inflammatory ointments can be applied for temporary anti-inflammatory treatment. However, to avoid the local complications such as thickening or branching of the fistula, it is advised that patients undergo surgical treatment of the anal fistula as soon as possible. (Please use medication under the guidance of a professional physician, and do not self-medicate.)

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Written by Yu Xu Chao

Colorectal Surgery

1min 11sec

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How to reduce swelling when an anal fistula flares up?

An anal fistula flare-up can cause perianal swelling, pain, and discharge of pus and blood. For an anal fistula flare-up, initial conservative treatment with medications is an option, such as sitting baths using anal cleansing agents or potassium permanganate solutions after defecation. The sitting bath should last between five to ten minutes to help reduce swelling and relieve pain. After the bath, topical application of mupirocin ointment or other anti-inflammatory ointments like Golden Ointment may also be used to reduce swelling and inflammation. For severe infections, intravenous or oral antibiotics may be prescribed to reduce inflammation. However, clinically, it is recommended to opt for surgical removal of the anal fistula as early as possible. Early removal of the internal opening and the fistula tract is necessary for a complete cure of the anal fistula. If an anal fistula repeatedly flares up, it can easily lead to the formation of more fistula branches, forming complex anal fistulas, increasing the difficulty of later surgeries and enlarging the wound surface post-operation.

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Written by Chen Tian Jing

Colorectal Surgery

1min 6sec

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How long does it take to recover after surgery for an anal fistula?

Healing after surgery for an anal fistula requires some time, and the longer healing duration is mainly related to two factors: The first reason is that anal fistula is a localized infectious disease of the anus with the presence of a fistula. The principle of surgery is primarily to remove the fistula. Therefore, after the surgery, the wound surface from the removed fistula wall is relatively large and requires time to heal. The second reason is that the local area around the anus is a contaminated wound, with feces passing through daily. Feces are a significant source of contamination, so the wound healing is influenced by the irritation from feces, resulting in a non-sterile wound environment. Consequently, the wound healing rate after the surgery is slower compared to the healing rate of sterile wounds in other body tissues. Therefore, the recovery time after anal fistula surgery is approximately 3 to 4 weeks.