Does anal fistula treatment ensure complete fistula healing?

Question

Hi doctor,

I was diagnosed with fistula-in-ano eight years ago. I just consulted multiple physicians and surgeons. They all said to wait and watch and put me on antibiotics. Two years later, my fistula has closed on its own, and there is no pus discharge or abscess forming. The healing was fast, and since then, I have had no problem at all. I do get some itching problems in the opening area when I do not follow a proper diet and eat any junk food or spicy food.

If I sit for a long time in the same position, then I can feel some pain in the same area, but there is no pus or abscess. But, there is a scar in the area where the fistula opening was, and when I touch it, it feels different than that of the other skin area. Can I consider this as my fistula has healed on its own? Is there any other problem that I should consider? What are the other precautions I have to take in order to make the area feel more comfortable? Is there any chance that the fistula can spread to other parts internally?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Fistula-in-ano is a surgical condition and cannot be cured by medicines alone. Yes, antibiotics have a minor role, mainly to prevent infection. If the fistula tract develops an infection, an abscess can develop from it, and later the fistula tract may extend.

The external fistula opening has fibrous tissue, which does not feel like normal skin. As this tissue is fragile, you may develop a small amount of bleeding while itching. For precaution, take all measures to prevent constipation, as hard straining is an aggravating factor for fistula.

During surgery, the doctor removes the fistula tract entirely and keeps the raw area open to avoid the chance of infection and to allow proper healing. This requires regular dressing and care, as the probable diagnosis is fistula-in-ano, and the treatment plan is surgical excision of the fistula.

The investigations to be done include;

Digital rectal examination.
Proctoscopy proctoscopy.
Fistulogram.

I hope this helps.

Thank you.