What should be paid attention to for anal fistula?

Written by Chen Tian Jing
Colorectal Surgery
Updated on December 16, 2024
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Patients with anal fistula, as there is an external opening in the anal region and intermittent thick secretion from this opening, should first ensure to keep the perianal area clean. It is recommended to change underwear daily and to cleanse the area after bowel movements with saline or hemorrhoid wash, and to conduct fumigation and hot compresses around the perianal area and the external opening to prevent irritation and even sharp pain caused by residual feces and secretions. Furthermore, during acute episodes of anal fistula, mupirocin ointment can be applied around the external opening for anti-inflammatory treatment. The definitive surgery for anal fistula primarily involves fistulotomy with seton placement. Without surgery, an anal fistula cannot be completely cured and may lead to worsened conditions such as thickening of the fistula wall or increased branching of the fistula channels.

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Written by Yang Dong
Colorectal Surgery Department
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causes of anal fistula

Anal fistula is one of the common diseases in proctology. The formation of an anal fistula is caused by infection of the anal sinuses and anal glands. Due to damage to the anal sinuses and anal glands, bacteria from the intestines enter these areas. As immunity weakens, the bacteria cause localized inflammation, which then leads to the formation of an abscess. After the abscess bursts, an anal fistula forms. This is the pathogenesis of anal fistula.

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Written by Chen Tian Jing
Colorectal Surgery
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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 Yang Dong
Colorectal Surgery Department
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What will happen if an anal fistula is not treated?

An anal fistula is a chronic fistula and duct caused by an infection of the anal sinuses. If not treated, an anal fistula may repeatedly flare up. The consequences of repeated occurrences can lead to abscesses, peripheral spreading, and eventually extensive spreading of the loose tissue around the anus, which in severe cases may damage the anal muscles, leading to anal incontinence. If an anal fistula persists for a long time, there is also a possibility of malignant transformation.

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Written by Yang Dong
Colorectal Surgery Department
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What is the most accurate test for anal fistula?

As a common disease in proctology, simple anal fistulas can be diagnosed through visual inspection and palpation. For high-positioned complex anal fistulas, which cannot be accurately assessed through just visual inspection and palpation, the use of instruments may be necessary. Currently, magnetic resonance imaging (MRI) is recommended as the most accurate method for evaluating anal fistulas, and it is considered the gold standard for examining the course of the fistula tract and the location of the infection.

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Written by Yang Dong
Colorectal Surgery Department
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Is the probability of anal fistula turning into cancer high?

An anal fistula, formed due to an anal gland infection, carries a higher risk of malignant transformation if the infection and inflammation are recurrent and persistent, particularly over a long period exceeding five years. Therefore, it is strongly recommended that anal fistulas exceeding five years should be given sufficient attention and surgical treatment should be pursued promptly to prevent malignancy.