Anal Fistula

Anal fistula is an abnormal connection/ pipeline between the anal canal and the anal skin.

The anus is the opening of the rectum where bowel movements (stools) leave the body. Inside the anus there are many small glands. If these glands are affected by infection, they get blocked. You did nothing to cause this infection. Certain conditions like constipation, diarrhea and other inflammation (swelling) of the intestine may cause these infections more likely. A cavity is formed around the infected area and pus develops inside the cavity. This is a normal defense method of your immunity to kill the infection causing germ. The collection of pus inside the cavity is called abscess. A small passage way is created from the anal gland to outer anal skin. The pus is drained via this passageway. If this passageway persist for long time, it becomes a fistula.

Internal and external openings in anal fistula

Causes of Anal Fistula

Fistulas can be seen as a birth defect (congenital). Other reasons for a fistula formation are:

  • Infection.
  • Surgery.
  • Injury.

symptoms of Anal Fistula

  • Fever, when the body tries to fight the infection.
  • Irritation of the skin around the anus.
  • Bleeding or pus discharge from the anus.
  • Constipation, as some people try to avoid defecaetion.
  • Pain with stool passing.
  • Swelling of the skin around the anus.

Diagnosing Anal Fistula

Physical examination-

The surgeon will examine the patient to find the opening of the fistula. A piled up tissue around the anus is suggestive of fistula in ano. Some fistulas can close all of a sudden. In those patients the drainage may be on and off. So at the time of the hospital visit, it might be hard to identify the fistula by the doctor. The Surgeon might prefer some imaging techniques to get a clear picture for his diagnosis.

Imaging techniques

  •  MRI is accurate for mapping the fistula tract and identifying internal openings in 90 percent cases.
  •  CT scan is useful for patients with complicated infections.
  •  Endoanal ultrasound can identify a horseshoe extension of the abscess.

Treatments for Anal Fistula

Anal fistula is a disease that has been occuring for ages. So a variety of treatment modalities had been implicated for years. Surgery is the best treatment that will close the anal fistula.

• Simple low anal fistulas can be cured by a simple surgery. The surgery for a simple fistula is known as a fistulotomy. It carries 21 percent risk of recurrence.

VAAFT (Video Assisted Anal Fistula Treatment) is the new surgical technique performed for the treatment of complex anal fistulas. It is a minimally invasive procedure. It helps in quicker recovery for patients. It has lesser recurrence.

Prevention of anal fistulas

  • Avoid wearing tight clothes
  • Shave regularly if you have excess hair
  • Avoid sitting for a long time

LIMA Advantages

Innovated Several Painless techniques

Anal Fistula Specialists

Dr. J. S. Rajkumar


M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)

Dr. R. Prabhakaran

Consultant Surgical Gastroenterology

Dr. S. Akbar

Consultant General and Laparoscopic Surgery