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

Written by Chen Tian Jing
Colorectal Surgery
Updated on November 26, 2024
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After surgery for an anal fistula, the general recovery time is about twenty days to a month. The duration of recovery mainly depends on the size of the local lesion before surgery, as well as the surgical wound postoperatively, and also relates to the patient's constitution. Particularly, if the patient has certain underlying diseases, such as diabetes or a history of tuberculosis, the recovery time may be relatively extended. The wound after an anal fistula surgery is an open wound contaminated with bacteria, so postoperative wound dressing changes are very important for wound recovery. It is recommended that the secretion from the local wound be cleared daily, followed by disinfection with povidone-iodine, then application of an anti-inflammatory ointment, and covering the wound with an oil gauze strip for drainage to avoid poor drainage leading to false healing of the local wound.

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Written by Yu Xu Chao
Colorectal Surgery
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Is a second surgery for an anal fistula more difficult than the first one?

Relative to the initial procedure, a second surgery for anal fistula is more difficult. The main goal of anal fistula surgery is to remove the internal opening and the fistula tract completely to cure the condition. During a second surgery for an anal fistula, due to the previous operation, the internal opening may be unclear, and it can be difficult to distinguish between the fistula and scar tissue. This can lead to incomplete removal by less experienced surgeons, increasing the likelihood of the fistula recurring later. Therefore, for a second surgery on an anal fistula, it is essential to undergo the procedure in a specialized colorectal department at a provincial-level top-rated hospital. It is recommended to have a magnetic resonance imaging (MRI) of the anal region before surgery to ensure precise operation and complete removal of the internal opening and fistula tract. Proper postoperative dressing changes are also crucial to avoid infection and inflammation of the wound, which will help with normal recovery after the surgery.

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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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Written by Yu Xu Chao
Colorectal Surgery
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What are the precautions after undergoing anal fistula surgery?

Because anal fistula surgery primarily involves removing the internal opening and the fistula tract, the postoperative wound is relatively large. Postoperative care mainly requires consistent dressing changes to ensure the wound drainage remains unobstructed, avoiding infection or false healing. Additionally, patients should develop good bowel habits, maintain smooth bowel movements, and avoid withholding stool. Otherwise, this may lead to dry, hard stools, causing severe pain during defecation or damaging the wound, which could result in bleeding or edema. In terms of diet, patients should choose foods rich in roughage to ensure smooth defecation and eat foods rich in high-quality protein to supplement the amino acids the body needs, promoting wound healing as much as possible. Moreover, after surgery, patients must use an anal wash or potassium permanganate solution for sitz baths. Since the postoperative wound is open and contaminated, changing dressings is especially important.

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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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Anal fistula etiology

The cause of an anal fistula is due to infection of the anal glands. In normal human anatomy, there is a location at the junction of the rectum and the anal canal called the anal sinus or anal gland, which is relatively weak. If it is damaged, intestinal bacteria can enter the anal gland, causing inflammation. Over time, the infected anal gland leads to further abscesses towards the perianal space, causing a perianal abscess. After the perianal abscess ruptures, it further develops into an anal fistula.