Anal Fistula: Stages, Symptoms & Treatment
A simple guide for patients to understand what an anal fistula is, how to detect it, and the treatment options available.
What is an anal fistula?
An anal fistula is an abnormal tunnel that forms between the inside of the anus/rectum and the skin around the anus. It usually develops after an untreated or recurrent anal abscess (pus collection). The tunnel often keeps leaking pus or fluid, leading to discomfort, infection, and skin irritation.
General symptoms patients notice
- Persistent pus or watery discharge near the anus
- Pain or swelling around the anal area
- Recurrent abscess formation (boils)
- Itching or skin irritation near the anus
- Blood-stained discharge (sometimes)
- Fever or fatigue in case of infection
How severity progresses
Stages of fistula & what to do
Stage 1: Simple fistula
Symptoms: Small external opening with occasional pus discharge, mild pain.
What to do: Consult a doctor early. Home remedies only control symptoms, not cure. Early surgical options like fistulotomy can be curative.
Stage 2: Moderate fistula
Symptoms: Frequent discharge, recurring abscesses, swelling, more discomfort.
What to do: Medical treatment is necessary. Procedures may include seton placement (a thread to drain pus) or fistulotomy depending on location.
Stage 3: Complex fistula
Symptoms: Multiple branching tracts, severe pain, continuous pus discharge, fever or infection.
What to do: Requires advanced surgical techniques like LIFT (ligation of fistula tract), VAAFT (video-assisted anal fistula treatment), or fistula plug.
Stage 4: Recurrent/complicated fistula
Symptoms: Fistula reappears even after treatment, involves deeper muscles, high risk of incontinence if ignored.
What to do: Needs expert colorectal surgeon care. Advanced surgeries with muscle-sparing techniques are preferred.
Prevention & self-care tips
- Treat anal abscesses early to avoid fistula formation
- Maintain good anal hygiene
- Eat a fiber-rich diet to prevent constipation
- Drink plenty of water
- Avoid prolonged sitting
- Do not ignore persistent pain or pus near the anus
When should you see a doctor?
- Persistent or recurrent pus/blood discharge
- Severe pain, swelling, or abscess formation
- Fever, weakness, or spreading infection
- Symptoms not improving with basic care
FAQs
Can fistula heal without surgery?
No. Unlike piles, fistula almost never heals on its own. Surgery is usually needed for a permanent cure.
Which doctor should I consult?
A general surgeon or a colorectal surgeon is the right specialist for fistula treatment.
Is fistula surgery painful?
Modern techniques (like LIFT, VAAFT, laser surgery) reduce pain and recovery time compared to traditional surgery.