An anal fistula is a small passageway that joins an abscess, or diseased tunnel in the anal orifice (anus), to a skin opening surrounding the anal orifice (anus).

The anal orifice (anus) is the external hole where fecal matter leaves. Numerous small mucus-producing glands are found inside the anus. These glands can become congested and infected, resulting in an abscess. Approximately half of these abscesses will develop into a fistula.


  • Bleeding
  • Pain
  • Swelling of the anus
  • Urination or bowel movement that is painful
  • Smelly discharge from the hole close to your anus
  • Redness
  • Fever


If the doctor suspects you have an anal fistula, they will request for your health history and conduct a physical exam.

Some anal fistulas are visible, while others are not. They tend to close and reopen on their own. If there are signs of fluid discharge or severe bleeding, the doctor will examine the patient. The doctor may choose to insert a finger into your anus during the examination to check for infection.

The doctor will most likely refer you to a colon and rectal specialist for additional tests or imaging tests, such as X-rays or a CT scan. Patients may also require a colonoscopy. A colonoscopy is a process that involves the insertion of a flexible, illuminated tool into the colon via the anal orifice (anus). It is carried out under conscious sedation, a mild anesthetic.


There is no medication used to treat the anal fistula condition. Instead, surgery is often used. The process is usually carried out in a physician’s office or clinic.

  • If a quick and easy fistula is not near enough to the anus, the doctor might well slit open the skin and muscle in an attempt to expand the passageway. 
  • In some cases, an artificial plug could close the anal fistula.
  • In the particular instance of a more complex and challenging fistula, the physician may insert a seton tube into the opening. It aids in the drainage of infected fluid before surgery.

Depending on the location of the fistula, the doctor might even have to cut into the sphincter muscle, which opens and close the anal orifice. 

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