Living with an anal fistula offers serious health considerations; however, it also can change the way you live your life and your happiness. Trust us to provide the specialized medical attention you need to get you back to feeling more like yourself.
An anorectal disorder occurs at the junction of your anal canal and rectum. Often treatment is available in your provider's office. For some care, you might need more complex treatments available at a hospital.
An anal fistula is a tunnel that forms between an infected anal gland and the skin on the outside of your body. This is a complication of an anal abscess. Fistulas usually start as an anal abscess. Over time abscesses create an abnormal tunnel to the skin surface so the infection can drain. About 25-30% of people with an anal abscess will develop a chronic anal fistula. Anal fistulas can cause persistent drainage around the rectum, even after treatment for the abscess.
The symptoms of an anal fistula are the same as the symptoms of an anal abscess. But the pain is not as bad and may happen only during a bowel movement. Other symptoms can include:
To check for an anal abscess or a fistula, your doctor or nurse will look at your anus and do a “digital rectal exam.” During the exam, your provider will put a gloved finger into your anus to feel for abnormalities.
He or she might also order an “imaging test,” such as an MRI or a CT scan. Imaging tests create pictures of the inside of the body. These images can help determine how severe or how large your abscess is.
Your doctor may also need to do other tests to check for inflammatory bowel disease or rectal cancer.
To treat a fistula, your doctor will need to cut open the abnormal tunnel that has formed. This will remove the pus and inflamed tissue, helping the wound heal. We do this surgery under anesthesia, where you are asleep. If you have a large or deep fistula, you might need treatment in the hospital for a few days.
The main concern with surgery is the development of anal incontinence. If the anal fistula is deep, the doctor may need to cut through the anal sphincter to open the tunnel. If your doctor needs to cut the anal sphincter entirely, it could result in anal incontinence.
Anal incontinence can include:
In up to 45 percent of patients, minor leakage can occur during the recovery period. This is normal. This immediate post-surgical incontinence is rarely permanent and is usually mild.
The risk of incontinence after surgery is higher:
Discuss all risks with your surgeon during your pre-surgery appointment.
The most important care instruction is to not allow yourself to become constipated. Staring the mornign after surgery, avoid constipation by:
