How is an anal fistula treated?

Written by Chen Tian Jing
Colorectal Surgery
Updated on January 17, 2025
00:00
00:00

The treatment methods for anal fistula mainly involve surgery. Conservative medication for anal fistula does not provide a definitive cure but can alleviate the inflammatory symptoms triggered during acute episodes by using anti-inflammatory symptomatic drugs. The surgical method primarily used for anal fistula is the fistulotomy with seton placement. This procedure involves cutting the local sphincter either partially or completely using a thread, while preserving the function of the surrounding sphincter and thoroughly removing the fistula tract wall to further eliminate the local lesions. After the surgery, due to the large wound area, it is recommended that patients stay in the hospital for dressing changes and symptomatic treatment to avoid complications like poor healing leading to pseudo-healing or wound infection. (Medication should be used under the guidance of a doctor.)

Other Voices

doctor image
home-news-image
Written by Yang Dong
Colorectal Surgery Department
33sec home-news-image

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.

doctor image
home-news-image
Written by Chen Tian Jing
Colorectal Surgery
1min 2sec home-news-image

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

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.

doctor image
home-news-image
Written by Chen Tian Jing
Colorectal Surgery
58sec home-news-image

The difference between perianal abscess and anal fistula

Perianal abscesses and anal fistulas both belong to local infectious diseases of the anus. A perianal abscess represents the acute phase of infection, characterized by significant localized subcutaneous swelling, heat, pain, and the formation of pus and abscesses. Once the pus breaks through the skin and discharges, it naturally forms an anal fistula. Anal fistulas represent the later stages or dormant phases of local infections. Both perianal abscesses and anal fistulas require surgical treatment. The surgical method for perianal abscesses mainly involves a one-time radical surgery for the abscess, while the surgical approach for anal fistulas primarily involves fistulotomy with seton placement, followed by regular wound cleaning and dressing changes post-surgery.

doctor image
home-news-image
Written by Yang Dong
Colorectal Surgery Department
28sec home-news-image

What are the symptoms of an anal fistula?

Anal fistula is one of the common diseases in proctology. The most typical symptom of anal fistula is recurrent anal induration, accompanied by swelling, pain, and pus discharge, often with a ruptured external opening. During the quiescent phase, a hard cord can be felt leading from the ruptured external opening to the inside of the anus; during the acute inflammatory phase or abscess phase, pressing may cause pus to ooze from the ruptured opening.

doctor image
home-news-image
Written by Yang Dong
Colorectal Surgery Department
27sec home-news-image

How long does it take for the rubber band of an anal fistula to fall off?

For high anal fistulas, we opt for the seton therapy, where we typically use rubber bands as the thread. For the rubber bands used in seton therapy, we believe it is best if they fall off around ten days. Therefore, for the anal fistula rubber bands, we think it is ideal if they fall off in about two weeks at the latest. If they have not fallen off after about two weeks, we may consider further interventions such as cutting the thread or directly cutting the sphincter muscle.