Anal Fistula Inflammation: Symptoms and Treatment Options

Inflammation of the anal fistula?

Hello, doctor.
I was previously diagnosed with an anal fistula, but I haven't experienced any significant discomfort, so surgery was not scheduled.
Recently, the affected area has suddenly become swollen and painful.
Will the swelling and pain resolve on their own? If I do not undergo surgery, could it develop into a more complicated fistula? Thank you for your response.

Miss Hsu, 30~39 year old female. Ask Date: 2018/11/11

Dr. Ke Fangxu reply Surgery

If a fistula becomes infected, it may cause swelling and pain.
Please consult a physician as soon as possible for medication.
If necessary, an incision and drainage may need to be performed.
If left untreated, it could potentially develop into a complex fistula in the future.

Reply Date: 2018/11/11

More Info

Anal fistulas are abnormal connections between the anal canal and the skin surrounding the anus. They often develop as a result of an infection in the anal glands, leading to the formation of an abscess. If left untreated, anal fistulas can cause significant discomfort and may lead to complications, including recurrent infections and the development of complex fistulas.

Symptoms of Anal Fistula Inflammation
The symptoms of an inflamed anal fistula can vary, but common signs include:
1. Pain and Discomfort: Patients often experience pain around the anus, which can worsen during bowel movements or when sitting.

2. Swelling: The area around the fistula may become swollen and tender to the touch.

3. Discharge: There may be pus or blood discharge from the opening of the fistula, which can be foul-smelling.

4. Itching: The area may become itchy due to irritation.

5. Fever: In some cases, a fever may develop if there is an associated infection.

Treatment Options
1. Conservative Management: In some cases, if the fistula is not causing significant symptoms, doctors may recommend a watchful waiting approach. However, this is usually not advisable if there is inflammation or pain, as these symptoms indicate that the fistula may be active and could worsen over time.

2. Surgical Intervention: Surgery is often the most effective treatment for anal fistulas. The type of surgery depends on the complexity of the fistula:
- Fistulotomy: This is the most common procedure, where the fistula tract is opened and allowed to heal from the inside out.

- Seton Placement: In cases of complex fistulas, a seton (a piece of surgical thread) may be placed to help drain the infection and allow the fistula to heal gradually.

- Flap Procedures: For more complicated cases, a flap procedure may be necessary to close the fistula.

3. Antibiotics: If there is an associated infection, antibiotics may be prescribed to help manage the infection before or after surgery.

Prognosis and Complications
If left untreated, an anal fistula can lead to complications such as:
- Recurrent Abscesses: The infection can recur, leading to repeated abscess formation.

- Complex Fistulas: These can develop if the initial fistula becomes more complicated, involving multiple tracts or extending into the anal sphincter.

- Incontinence: In severe cases, surgical treatment may be necessary to prevent damage to the anal sphincter, which can lead to incontinence.

Conclusion
In your case, since you are experiencing swelling and pain, it is crucial to consult with a healthcare provider. While some anal fistulas may not cause significant discomfort initially, the presence of inflammation and pain suggests that intervention may be necessary to prevent complications. Surgical options are generally effective and can significantly improve quality of life. It is essential to discuss your symptoms and treatment options with a qualified healthcare professional to determine the best course of action for your specific situation.

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Will anal fistulas continue to occur?

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Hello: In response to your question, an anal fistula is a complication that arises after inflammation of the anus. The only definitive treatment is surgery; without surgical intervention, the anal fistula will not heal on its own.