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 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 Chen Tian Jing
Colorectal Surgery
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What causes anal fistulas?

The most common cause of anal fistula is perianal abscess. Both anal fistula and perianal abscess involve infections at the anal crypts. Typically, an anal fistula forms naturally after a perianal abscess ruptures. Once an anal fistula occurs, it requires prompt surgical treatment. The primary surgical technique is fistulotomy with seton placement, thoroughly removing the local lesion and infection focus to allow fresh granulation tissue to regrow. Anal fistula is a local infectious disease of the anus, generally categorized into simple superficial anal fistula and high-risk complex anal fistula. If a high-position complex anal fistula is suspected, further diagnosis may require additional examination with pelvic MRI or perianal ultrasonography. After the rupture of a perianal abscess, it typically forms a characteristic internal and external opening, with a fistula tract connecting them, thereby forming the typical anal fistula.

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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.

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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 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.