Treating Anal Fistulas

Alan has been suffering from pain in his butt cheek for more than a year. Originally diagnosed as hemorrhoids, the pain continued despite treatment and eventually became an open wound. Now, Alan has constant drainage from the area. Gastroenterologist Dr. Jorge Rodriguez examines Alan and determines that the source of the problem is most likely an anal fistula — a canal leading from the colon all the way out to the skin.

"It may have started as an abscess," Dr. Rodriguez explains, "but with time, the inflammation ate its way both to the outside and into the colon, where what he has now is a canal that flows stool or mucus. No wonder it doesn't heal; this thing is flowing bacteria there 24/7, and it can be a very serious condition."

Proctologist Dr. David Rosenfeld explains that that there are four to six glands in the anus that assist in the evacuation of bodily waste by secreting mucus. When an anal gland gets blocked, the gland becomes infected, leading to an abscess. If the abscess doesn't drain, the pressure will push the bacteria out through the skin, creating another opening. Consequently, stool is able to get inside the hole, travel along the fistula canal and drain out through the corresponding opening on the skin.

Treating Anal Fistulas

Dr. Rosenfeld describes the surgery to correct a fistula. "It's about 95 percent effective. [The fistula] won't come back."

Common symptoms:

• Pain
• Redness
• Swelling around anal area
• Fatigue
• General malaise
• Fever or chills
• Irritation of the perianal skin or drainage from an external opening

Fistulas rarely heal on their own, even when treated with antibiotics. Without surgery, recurrent infections and persistent drainage — such as that experienced by Alan — are likely to occur.


Hemorrhoids vs. anal fissures
Is it a hemorrhoid?
Treating anal fissures
How nutrition affects digestive health  
Rectovaginal fistula explained