Symptoms of hemorrhoids and anal fistula

Written by Chen Tian Jing
Colorectal Surgery
Updated on November 16, 2024
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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 Yu Xu Chao
Colorectal Surgery
1min 6sec home-news-image

Is it better for the external opening of an anal fistula to be closed or not closed?

In clinical practice, it is generally best not to close the external opening of an anal fistula. Keeping the drainage unobstructed can prevent the infection from worsening or the formation of multiple branches. This is because when the fistula drains properly, the infectious secretions can flow out of the external opening. However, if the external opening does close, the infected tissues and secretions will accumulate within the fistula and then spread to the surrounding areas, forming branches and leading to an increase in the number of branches, thus creating a complex anal fistula and increasing the difficulty of future surgeries. Therefore, it is best not to close the external opening of an anal fistula. Clinically, the treatment for an anal fistula involves fistulectomy, which primarily involves removing the internal opening and the fistula. The external opening also needs to be treated. Postoperatively, medications such as erythromycin ointment gauze strips should be used for dressing changes.

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Written by Yu Xu Chao
Colorectal Surgery
1min 15sec home-news-image

Are hemorrhoids the same as anal fistulas?

Hemorrhoids and anal fistulas are two completely different diseases. Clinically, hemorrhoids can be divided into mixed hemorrhoids, internal hemorrhoids, and external hemorrhoids. Internal hemorrhoids are often characterized by intermittent, painless rectal bleeding, while external hemorrhoids primarily cause symptoms such as a foreign body sensation in the anus and itching. For the treatment of hemorrhoids, if the condition severely affects the patient's normal life, surgical treatment can be considered, such as external peeling and internal ligation surgery, and internal hemorrhoid banding. Anal fistulas are mainly due to perianal abscesses that rupture spontaneously or are incised and drained, subsequently forming an anal fistula, which causes the patient to experience recurrent perianal swelling pain and pus and bloody discharge. Treatment for anal fistulas can only be surgical, and early surgical intervention tends to result in relatively fast postoperative recovery. The surgery mainly involves the removal of the internal opening and the fistula tract, followed by diligent postoperative dressing changes to promote wound healing.

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Written by Chen Tian Jing
Colorectal Surgery
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What to do about the false healing of anal fistula?

If a false healing of the wound occurs after local surgical excision of an anal fistula, it is mainly due to improper dressing changes by the patient and a lack of timely observation of the local wound. It is recommended to open the superficially healed wound to allow it to regrow. In particular, the patient needs to change the dressing and observe the wound daily to prevent the situation where the internal part of the wound has not healed, but the external opening appears healed. During dressing changes, hemorrhoid creams and other drugs that promote mucosal healing can also be applied locally and inside the anal canal to further promote the healing of the internal opening. Only when the internal opening has fully grown should treatment that promotes healing of the external opening be applied. (Please use medication under the guidance of a professional physician, and do not self-medicate.)

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Written by Deng Heng
Colorectal Surgery
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Can anal fistulas be contagious?

An anal fistula is a pathological channel that forms a connection between the anal canal, rectum, and the skin around the anus. It primarily develops from an infection causing a perirectal abscess around the rectal anal canal. These infections are generally purulent, with a smaller number due to tuberculosis. Other specific infections, such as Crohn's disease or ulcerative colitis, can also lead to anal fistulas. Generally, such infections are caused by Escherichia coli, leading to purulent infections; tuberculosis can be contagious, but generally, it is not infectious or contagious.

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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.