Anal Fistulas: Symptoms, Treatment, and When to Seek Help - Surgery

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Understanding anal fistulas is crucial for anyone experiencing symptoms related to this condition. An anal fistula is an abnormal connection between the anal canal and the skin surrounding the anus. It often arises from an infection in the anal glands, leading to the formation of an abscess. Here, I will discuss the symptoms, treatment options, and when to seek medical help.


Symptoms of Anal Fistulas
The symptoms of anal fistulas can vary, but common signs include:
1. Pain or Discomfort: While you mentioned that the protruding mass was not painful, many individuals experience discomfort or pain, especially during bowel movements.

2. Swelling or a Lump: The presence of a lump near the anus, which can be tender or swollen, is a common symptom.

3. Discharge: There may be pus or blood discharge from the opening of the fistula, which can lead to irritation of the surrounding skin.

4. Itching or Irritation: As you noted, a burning sensation or itching around the anus can occur.

5. Recurrent Abscesses: If you have had previous abscesses in the anal area, this could indicate an underlying fistula.


Treatment Options
The treatment for anal fistulas typically depends on the severity and complexity of the fistula. Here are some common approaches:
1. Observation: In cases where the symptoms are mild and the fistula is not causing significant issues, doctors may recommend a watchful waiting approach, as you experienced previously.

2. Medications: Topical treatments or antibiotics may be prescribed to manage any infection or inflammation.

3. Surgical Intervention: If the fistula does not heal on its own or if it causes recurrent problems, surgical options may be necessary. Surgery aims to remove the fistula while preserving the surrounding sphincter muscles to prevent incontinence.


When to Seek Help
You should consider seeking medical attention if:
- The symptoms worsen or do not improve after a few days.

- You experience increased pain, swelling, or discharge.

- You notice a fever or other signs of infection.

- The fistula reoccurs or if you have a history of recurrent anal abscesses.


Finding the Right Specialist
In terms of finding a hospital or specialist in Taipei, you should look for a colorectal surgeon or a gastroenterologist who specializes in anal disorders. Major hospitals in Taipei, such as National Taiwan University Hospital or Taipei Medical University Hospital, have departments that handle such conditions. It’s advisable to call ahead and inquire if they have specialists experienced in treating anal fistulas.


Conclusion
While your symptoms may seem manageable at the moment, it’s essential to monitor them closely. If the protruding mass returns or if you experience any worsening symptoms, do not hesitate to seek further medical evaluation. Early intervention can prevent complications and improve your quality of life. Remember, it’s always better to err on the side of caution when it comes to your health.