Anal fistula: causes, diagnosis and treatment

Written by: Dr. Eloy Espín Basany
Published: | Updated: 17/11/2018
Edited by: Top Doctors®

An anal fistula is a communication (tunnel) between the skin surrounding the anus and the interior of the rectum. In some cases the anal fistula occurs as a manifestation of other pathologies, such as Crohn's disease.


Causes of an anal fistula

The origin of the anal fistula is usually an abscess that has drained to the skin, causing a communication between the anal fistula and the interior of the anus or rectum. Only in half of cases of drainage of an abscess will an anal fistula result.

The anal fistula is a communication between rectum and anus

How to diagnose an anal fistula

The anal fistula is manifested by the chronic discharge of pus or feces from the hole in the fistula located in the skin of the anus.

For the diagnosis of fistula, the most important criterion is the anal examination by a surgeon specialized in Coloproctology. Imaging tests such as anal ultrasound or a pelvic MRI may sometimes be needed.


Treatment for anal fistulas

Anal fistulas are classified as simple or complex , depending on the degree of anal sphincter involvement .

The treatment to be used is surgery , and the technique varies according to the type of fistula and according to the patient's history and local conditions (history of anal surgeries, inflammatory disease or other risk factors for the appearance of anal incontinence). In most cases, the fistula is simple and can be treated on an outpatient basis. Thus, the patient only remains for a few hours in a hospital. In these cases and, usually, you can return to work activities in a short period of time.

When the fistulas are complex the treatment of the fistula is more laborious and requires a great experience on the part of the specialist in Coloproctology to decide which of the present techniques is the most suitable for the patient and for his type of fistula. At present, there are treatments such as LIFT ( minimally invasive surgery of the anus ), stoppers , tails , lasers , clips and even, in very selected cases, the use of stem cells .

Not all options are ideal for all fistulas and for all patients. In order to minimize the risk of complications such as relapse, incontinence or others, it is of vital importance that the surgeon who evaluates and treats patients has a great experience in this pathology.

*Translated with Google translator. We apologize for any imperfection

By Dr. Eloy Espín Basany
Colon & Rectal Surgery

Dr. Espin Basany coloproctólogo is a leading specialist in surgery of the colon, rectum and anus. He has trained at prestigious international centers such as the University of Minnesota. At present, he works as a specialist in the Teknon Medical Center and is also Chief Clinical Unit Colon and Rectal Surgery Service of General and Digestive Surgery Hospital Vall d'Hebron in Barcelona. She combines her profession with teaching, working as Professor in the Department of Surgery at the Autonomous University of Barcelona.

*Translated with Google translator. We apologize for any imperfection

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