Anal Fistula: Understanding the Condition That Keeps Coming Back
An anal fistula is one of those conditions that can frustrate both patients and doctors. It often starts with a painful abscess near the anus, which may drain on its own or require surgical drainage. You feel relieved. But then, weeks or months later, it comes back. Or there's persistent drainage. That's when a fistula is likely present.
Understanding what a fistula is and how it can be treated effectively is the first step toward permanent relief.
What is an anal fistula?
An anal fistula is a small tunnel that forms between the inside of the anal canal and the skin near the anus. It's the body's attempt to create a path for drainage after an infection.
Think of it like this:
An abscess (a collection of pus) forms in the tissue around the anus. When the abscess bursts or is drained, it leaves behind a tunnel connecting the infected gland inside the anal canal to an opening on the skin outside. This tunnel is the fistula — and it doesn't heal on its own.
How does it develop?
Infection in anal glands
Small glands inside the anal canal can become blocked and infected
Abscess formation
The infection spreads into the surrounding tissue, creating a pocket of pus
Drainage or rupture
The abscess drains through the skin or is surgically drained
Fistula remains
A tunnel persists between the gland and skin opening, continuing to drain
Symptoms of an anal fistula
Persistent drainage of pus, blood, or stool from an opening near the anus
Recurrent abscesses in the same area
Pain or swelling around the anus
Irritation of the skin around the anus due to constant moisture
Foul-smelling discharge
Fever and general feeling of being unwell (if there's active infection)
Who is at risk?
Anyone can develop a fistula, but some people are at higher risk:
- • People who have had a perianal abscess
- • Individuals with Crohn's disease (an inflammatory bowel disease)
- • Those with tuberculosis or HIV
- • People with chronic diarrhea
- • History of radiation therapy to the pelvic area
- • Previous anal surgery or trauma
Why fistulas don't heal on their own
Critical fact:
Unlike a simple wound, a fistula is a tunnel with two openings. As long as the internal opening (inside the anal canal) remains connected to the external opening (on the skin), the tract stays open and continues to drain. The only way to heal a fistula is to close this tunnel — and that requires treatment.
Treatment options
Traditional surgery: Fistulotomy
The most common surgical treatment is a fistulotomy, where the entire fistula tract is laid open and allowed to heal from the inside out.
Pros:
- • High success rate
- • Single procedure
- • Well-established technique
Cons:
- • Open wound that takes weeks to heal
- • Risk of incontinence if sphincter muscle is involved
- • Requires regular wound dressing
Modern approach: Laser FILAC (Fistula-tract Laser Closure)
At Aegis Surgical Hospital and Laser Piles Center, Dr. Ratnadip Sonawane offers Laser FILAC — a sphincter-preserving, minimally invasive procedure for treating anal fistulas.
How Laser FILAC works:
A laser fiber is inserted into the fistula tract
Laser energy destroys the lining of the tract and seals the fistula from within
The internal and external openings are closed
The fistula collapses and heals naturally
Benefits of Laser FILAC:
Other advanced techniques
Seton placement
A thread is placed through the fistula to allow gradual healing while maintaining drainage
LIFT procedure
Ligation of Intersphincteric Fistula Tract — a sphincter-preserving technique
Flap procedures
Used for complex fistulas involving the sphincter muscle
Recovery and prevention
After treatment, following your surgeon's instructions is crucial to ensure healing and prevent recurrence.
Post-treatment care:
- → Keep the area clean and dry
- → Take warm sitz baths to promote healing
- → Maintain soft stools with a high-fiber diet and plenty of water
- → Avoid straining during bowel movements
- → Take prescribed medications as directed
- → Attend follow-up appointments to monitor healing
Get the Treatment You Need
If you're dealing with recurrent abscesses or persistent drainage, don't wait. Book a consultation with Dr. Ratnadip Sonawane at Aegis Surgical Hospital and Laser Piles Center to explore modern, minimally invasive treatment options.
Email: aegispilescare@gmail.com