What is Fistula?

An abscess that develops near the anal mucosal tissues can gradually expand and worsen over time. If left untreated, it may eventually break through the skin, forming an infected tunnel between the skin and the anus, leading to an anal fistula.

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Identifying the Signs

Discharge of pus or blood from an opening near the anus

Discharge of pus or blood from an opening near the anus is a common symptom of an anal fistula. This occurs when an infected anal gland forms an abscess that eventually drains, creating a tunnel between the anal canal and the skin

Recurrent infections or abscesses in the same area

Recurrent infections or abscesses in the same area may indicate the presence of an anal fistula or an underlying condition affecting the anal glands. When an abscess fails to heal completely, it can repeatedly fill with pus, causing swelling, pain, and discomfort

Low-grade fever and general malaise

Low-grade fever and general malaise are common symptoms associated with an anal abscess or fistula, indicating an ongoing infection. A persistent low-grade fever suggests that the body is fighting the infection, while general malaise—fatigue, weakness, or a sense of discomfort—can result from systemic inflammation.

Pain or discomfort while sitting, painful bowel movements, and possible bleeding

Pain or discomfort while sitting, painful bowel movements, and possible bleeding are common symptoms of anal fistulas, haemorrhoids, or anal abscesses. These symptoms occur due to inflammation, infection, or pressure on the affected area.

Persistent pain around the anus and skin irritation

Persistent pain around the anus and skin irritation can be symptoms of several conditions, including anal fistula, haemorrhoids, anal abscess, or fissures. These symptoms often result from inflammation, infection, or prolonged irritation of the anal tissues.

Swelling, redness, and tenderness near the anus

Swelling, redness, and tenderness near the anus are common signs of an anal abscess or anal fistula. These symptoms indicate localized infection and inflammation, often accompanied by pain and discomfort, especially while sitting or during bowel movements.

Types

Anal Fistulas

Anal Fistula – Develops between the anal canal and the skin around the anal opening.
Rectovaginal Fistula – Forms between the rectum or anus and the vagina.
Colovaginal Fistula – Occurs between the colon and the vagina.

Intestinal Fistulas

Enteroenteric Fistula – A connection between two segments of the intestine.
Enterocutaneous Fistula – A passage linking the intestine to the skin.
Colocutaneous Fistula – A connection between the colon and the skin.

Urinary Tract Fistulas

Vesicovaginal Fistula – A connection between the bladder and the vagina, leading to continuous urine leakage.
Urethrovaginal Fistula – Develops between the urethra and the vagina, causing urine to pass through the vagina.
Vesicouterine Fistula – A rare fistula between the bladder and the uterus, sometimes causing urine leakage from the uterus.

Miscellaneous

Enterovesical Fistula – Connects the intestine to the bladder, causing urinary tract infections and the presence of gas or fecal matter in urine.
Gastrocolic Fistula – Forms between the stomach and the colon, leading to diarrhea, weight loss, and malnutrition.
Bronchoesophageal Fistula – An abnormal passage between the esophagus and the bronchi, causing coughing while eating and recurrent lung infections.

Causes

Crohn's disease or other inflammatory bowel diseases

Fistulas – Abnormal connections between the intestines and other organs (common in Crohn’s disease). Strictures – Narrowing of the intestines due to inflammation and scarring. Abscesses – Pockets of infection that cause pain and fever. Malnutrition – Due to poor nutrient absorption. Colon Cancer Risk – Increased in long-term cases of IBD

Infections in the Anal Area from Sexually Transmitted Diseases (STDs)

Safe Practices – Using protection (e.g., condoms) can reduce the risk of transmission.Regular Screening – Early detection helps in effective treatment. Medical Treatment – Antibiotics or antiviral medications can manage most infections

Surgery or Radiation Treatment for Anal Cancer

Anal cancer is typically treated with a combination of radiation therapy, chemotherapy, and in some cases, surgery. The choice of treatment depends on the stage and severity of the cancer Local Resection – Removes small tumors while preserving anal function, used for early-stage cancers

Previously Drained Anal Abscesses

An anal abscess is a collection of pus near the anus or rectum, often caused by blocked anal glands, infections, or conditions like Crohn’s disease. If left untreated, it can develop into a fistula (an abnormal tunnel between the anal canal and the skin Recurrent Abscesses – Infections may return if the underlying cause is not treated

Trauma or Continuous Pressure on the Anal Area

Haemorrhoids (Piles) – Swollen veins in the anal canal. Anal Fissures – Painful tears in the anal lining. Abscesses & Fistulas – Infections leading to pus formation and abnormal connections between tissues. Pelvic Floor Dysfunction – Weakening of muscles controlling bowel movements

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