A FISTULA IS DEFINED AS AN ABNORMAL TRACT OR PASSAGEWAY THAT CONNECTS TWO OTHERWISE distinct organs within the body to each other. An anal fistula is, therefore, a channel that connects the anal canal to another part of the body (such as the skin surface). These channels may be divided into two broad categories: simple, consisting of a single tract, or complex, with several tracts and openings leading in and out of the region.

Anal fistulas are usually related to benign diseases such as anal gland infections and anal abscesses located around the anal region, although they may sometimes also be related to more serious causes such as cancer or Crohn’s disease (a form of inflammatory bowel disease). If left untreated, these fistulas may sometimes cause cancer as the constant inflammation of the region may eventually lead to cellular mutation that turns cancerous.

For the most part, however, most anal fistulas are what we call cryptoglandular, or a fistula that results from the infection of the patient’s anal glands. This type of anal fistula is most common amongst young men and often results in faecal incontinence.

Many patients often ask: What can I do to prevent myself from developing an anal fistula? The truth of the matter is that there’s nothing you can do to prevent it. It is not, as some people believe, due to diet, hygiene or even anal sex.

My personal research indicates that the severity of the fistula usually depends on how deep the patient’s anal glands are; the deeper the anal glands are located, the more severe the condition tends to be. If a patient is thus predisposed to the development of anal fistulas, there is nothing he or she can to prevent it.

Such patients usually present with swelling near or around the anus in addition to fever and discharge of pus (mixed with blood if an abscess is also present). This discharge is also often responsible for causing itchiness or chafing around the anal region, making that another common symptom of the presence of a fistula.

While the presence of an anal fistula may usually be diagnosed based on the patient’s symptoms, medical history and clinical inspection, the detailed anatomy of the fistula may only be understood by the performance of an examination technique known as diagnostic anal fistuloscopy, a minimally invasive procedure performed through a scope that is inserted into the anal region. This procedure will provide the doctor with details of the tract’s structure in addition to the internal details of the fistula.

Once appropriately diagnosed, anal fistulas are usually treated through surgery, where the entire tract that makes up the fistula is opened up and the overlying skin and muscle cut. This causes the fistula to heal from the base of the cut, allowing the body to heal itself completely when the skin covers the new growth.

If the fistula is too complex or is found growing too deep in the body, other methods must be employed as a large number of muscles will become involved the surgery, resulting in too much injury to the anal muscle (which in turn usually leads to anal incontinence). In such cases, the surgeon may opt for other surgical methods such as the use of anal fibrin glue, the insertion of a fibrin plug or the application of a seton.