Anal Fistulas: Healing and Treatment Insights

Regarding anal fistulas?

Hello Dr.
Yu, I would like to ask about a previous abscess above the anus.
After seeking medical attention, it was drained and formed a small opening.
Later, the doctor suspected it might be an anal fistula, but the wound has been healing over the past few days.
Is it possible that it has healed? Thank you for your response.

TT, 30~39 year old female. Ask Date: 2015/11/04

Dr. Yu Mingchang reply Surgery

Hello; it's not good, surgery is needed.
The Changhua Hospital of the Ministry of Health and Welfare is concerned about you.

Reply Date: 2015/11/04

More Info

Anal fistulas are abnormal connections that form 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. Once the abscess is drained, a fistula can form if the infection does not heal properly.
In your case, it sounds like you had an abscess that was drained, and subsequently, a small opening (or "small hole") formed. This is a common scenario in the development of anal fistulas. The fact that the wound appears to be healing is a positive sign, but it does not necessarily mean that the fistula has completely resolved.
Healing of the external wound does not guarantee that the internal connection (the fistula) has closed. Sometimes, the external opening may close while the internal tract remains open, which can lead to recurrent infections or complications in the future. Therefore, it is essential to monitor the area for any signs of recurrence, such as pain, swelling, or discharge.

Here are some insights regarding the healing and treatment of anal fistulas:
1. Observation: If the external wound is healing and you are not experiencing any pain or discharge, your doctor may recommend a period of observation. However, it is crucial to follow up with your healthcare provider to ensure that the internal fistula is also healing.

2. Surgical Intervention: If a fistula is confirmed, surgical treatment is often necessary. The type of surgery depends on the fistula's complexity and location. Common procedures include fistulotomy (opening the fistula tract), seton placement (a drain to allow for healing), or advancement flap procedures.

3. Postoperative Care: After surgery, proper care is essential for healing. This includes maintaining good hygiene, using sitz baths, and possibly taking stool softeners to minimize straining during bowel movements.

4. Follow-Up: Regular follow-up appointments with your healthcare provider are crucial to monitor healing and address any complications early.

5. Lifestyle Modifications: Dietary changes, such as increasing fiber intake and staying hydrated, can help prevent constipation and reduce strain during bowel movements, which is beneficial for healing.

In conclusion, while the healing of the external wound is a positive sign, it is essential to have a thorough evaluation by your healthcare provider to determine if the fistula has completely healed. If you have any concerns or notice any new symptoms, do not hesitate to reach out to your doctor for further assessment and guidance.

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