An anal fistula is an abnormal communication between the lining of the anus and the skin around the anus or buttock. Essentially it is a tunnel under the tissues communicating the two surfaces, one internal and one external.
An anal fistula usually results from an episode of anal infection, the patient having an abscess burst near the anus. The abscess starts from a blocked gland in the anus which then bursts into the tissues around the anus. This usually produces a few days pain around the anus but for no obvious reason. The infection then grows in size until it reaches the skin and bursts through. Once it has burst, there is often immediate relief of the pain but the patient often notices a continuous minor discharge from the skin. This is because as the abscess heals the hole in the skin that it burst through it invariably connects to the original gland in the anus that caused the infection, thereby creating a tunnel or fistula.
The fistula at this stage will not heal on its own and if it gets blocked again will produce another abscess. Therefore, by definition, anyone who gets two abscesses near the anus in the same position has a fistula. The only way to get rid of the tunnel or fistula is by surgery.
Fistulas are often associated with Crohn’s disease and sometimes may be the first indication that someone has Crohn’s disease.
The difficulty with fistula surgery around the anus is the the tunnel passes through the sphincter or continence muscles of the anus and despite appearing as a straightforward problem requires highly specialised knowledge and surgery. If you think you may have a fistula then you must see a specialist proctologist.
For a consultation and assessment of your condition please contact Dr. Gold.