Is It an Anal Fistula? Symptoms and Diagnosis

Inquire whether it is an anal fistula?

Hello doctor, I would like to inquire about a tubular structure I felt between the area above the anus and the scrotum.
There is a small wound on top of the tubular structure.
During the period of the wound, there hasn't been much pus, but after a couple of days of healing, the wound turns whitish.
When I squeeze it, it appears to ooze pus.
Could this be a fistula?

Lao Guan, 30~39 year old female. Ask Date: 2019/09/23

Dr. Ke Fangxu reply Surgery

If this phenomenon occurs repeatedly, it could be indicative of an anal fistula, but it may also simply be an infection in the perineal area that has not been fully resolved.
It is advisable to have a thorough examination by a colorectal surgeon to obtain a definitive diagnosis and initiate treatment to avoid any delay in addressing the condition.

Reply Date: 2019/09/23

More Info

Based on your description, it sounds like you may be experiencing symptoms consistent with an anal fistula. An anal fistula is an abnormal connection between the anal canal and the skin near the anus. It often develops as a result of an infection in the anal glands, leading to the formation of an abscess. When the abscess drains, it can leave a small tunnel or tract, which is what we refer to as a fistula.

The symptoms you describe—such as the presence of a tubular structure, a small wound, and the discharge of pus—are indeed indicative of a possible anal fistula. The fact that you notice a white discharge and that the wound seems to heal only to become inflamed again suggests that there may be an ongoing infection or irritation in that area.

Symptoms of an Anal Fistula:
1. Pain and Discomfort: You may feel pain around the anus, especially during bowel movements or when sitting.

2. Swelling and Redness: The area around the fistula may appear swollen and red.

3. Discharge: Pus or blood may drain from the opening of the fistula, which can be intermittent.

4. Itching or Irritation: The area may feel itchy or irritated due to the discharge.

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

Diagnosis:
To confirm whether you have an anal fistula, a healthcare provider will typically perform a physical examination. They may also use imaging studies such as an MRI or an endoanal ultrasound to visualize the fistula tract and assess its complexity.

Treatment:
If diagnosed with an anal fistula, treatment options may include:
- Surgical Intervention: Most anal fistulas require surgical treatment to properly heal. The type of surgery will depend on the complexity of the fistula.

- Antibiotics: If there is an infection, antibiotics may be prescribed.

- Sitz Baths: Warm baths can help relieve discomfort and promote healing.

When to Seek Medical Attention:
It is important to consult a healthcare provider if you suspect you have an anal fistula, especially if you are experiencing significant pain, fever, or persistent discharge. Early intervention can prevent complications and lead to better outcomes.

In summary, based on your symptoms, it is advisable to see a colorectal surgeon or a gastroenterologist for a thorough evaluation. They can provide a definitive diagnosis and discuss the best treatment options for your condition. Do not hesitate to seek medical advice, as timely intervention is crucial in managing anal fistulas effectively.

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