Is anal fistula prone to recurrence?

Written by Chen Tian Jing
Colorectal Surgery
Updated on December 03, 2024
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If active anal fistulotomy and thread-drawing surgery are carried out after the onset of an anal fistula, it generally does not recur easily. However, if patients do not pay attention to good dietary and defecation habits after being discharged, it may lead to the reoccurrence of the anal fistula. This is because there are multiple anal crypts within the anal canal, and removing the local anal crypts during this episode does not guarantee that other anal crypts will not become inflamed or infected in the future. Especially when patients consume excessive amounts of chili peppers or alcohol, or when they experience diarrhea, it can potentially trigger another infection of the anal crypts. Therefore, to prevent recurrence of anal fistulas, it is necessary to cultivate good defecation and dietary habits to avoid the reoccurrence of anal fistulas.

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Written by Yang Dong
Colorectal Surgery Department
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Consequences of recurrent anal fistulas

If an anal fistula is not treated in time, it may repeatedly occur. If an anal fistula repeatedly occurs, due to local inflammation, pus will spread and infiltrate into the perianal tissues, causing further aggravation of infection. This can then affect the function of the anus, potentially leading to symptoms such as fecal incontinence. Moreover, if an anal fistula repeatedly occurs over a long period, there is a possibility of malignant transformation.

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Colorectal Surgery
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Can an anal fistula be left untreated for a lifetime?

If diagnosed with an anal fistula, one should not forego treatment indefinitely, as an anal fistula is a localized infectious disease of the anal region. Without active treatment, the infection may further spread, increase the number of fistula branches, and potentially induce a high, complex anal fistula. There is also a risk that the fistula and the infection might penetrate the local anal sphincter, reaching the ischioanal fossa and causing other infectious diseases. The primary treatment method for anal fistulas is surgical, mainly involving fistulotomy with seton placement, which thoroughly removes the local infection, allowing the anal fistula to heal. Neglecting active treatment could worsen the condition or increase the difficulty of future surgeries.

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Written by Chen Tian Jing
Colorectal Surgery
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Which is more serious, anal fistula or hemorrhoids?

Anal fistulas and hemorrhoids are two different types of common colorectal diseases; neither can be said to be more severe than the other, as the severity of each disease depends on its progression and extent. If it's a simple superficial anal fistula, the severity is generally mild, primarily treated with surgery. However, if a high, complex anal fistula is present, in addition to surgery, a comprehensive pelvic MRI examination is also required to rule out any infections in the deep sphincter and ischioanal fossa. The severity of hemorrhoids primarily involves circular mixed hemorrhoids, or those accompanied by incarceration. If circular mixed hemorrhoids with incarceration occur, it is advisable to undergo surgical treatment as soon as possible to avoid necrosis. If hemorrhoids result in persistent and significant rectal bleeding, surgery should also be performed promptly to prevent anemia in the patient.

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Written by Chen Tian Jing
Colorectal Surgery
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Symptoms of hemorrhoids and anal fistula

If there are concurrent hemorrhoids and anal fistulas, then the clinical manifestations primarily involve the combined symptoms of both conditions. The clinical manifestations of hemorrhoids mainly include recurrent prolapse of local swellings at the anus along with defecation bleeding or pain. As for anal fistulas, they primarily present with local infectious symptoms at the anus because anal fistulas have distinct external and internal openings. During acute episodes, there typically is intermittent discharge of pus from the external opening along with accompanying stabbing pain. If the patient also has hemorrhoids or an exposed anal fissure, it is recommended to proceed with surgical treatment as soon as possible. The only treatment method for anal fistulas is surgery. During the surgery, while excising the wall of the anal fistula tract, mixed hemorrhoids can also be removed simultaneously, achieving the purpose of complete cure.

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Written by Yang Dong
Colorectal Surgery Department
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What color is the pus from an anal fistula?

An anal fistula is a sinus tract and fistula formed from an infection of the anal sinuses and glands. During the infection phase, there is a possibility of swelling, pain, and pus discharge. This discharge may be yellow pus or pus mixed with blood. Regardless of the color, it is crucial to seek prompt medical treatment at a hospital and undergo thorough treatment, rather than attempting conservative treatment on one's own.