Anal Fistula: Symptoms, causes, diagnosis & treatment in Bangladesh

An anal fistula is a condition that affects the anal region, causing discomfort and potential complications if left untreated. Understanding the symptoms, causes, diagnosis, and available treatments is crucial for individuals in Bangladesh to seek timely medical assistance and improve their quality of life.

What is Anal Fistula?

An anal fistula is an abnormal passage that connects the anal canal or rectum to the skin around the anus. It often develops after an anal abscess has drained spontaneously or been surgically opened to release pus. The fistula may cause pain, discomfort, and other symptoms, highlighting the importance of early recognition and treatment.

It can be divided into 2 main types:

  • Simple fistulas are easy to treat; they are shallow, short, and small.
  • Complex ones have more complicated issues, such as length and depth.
Anal Fistula Symptoms

Symptoms of Anal Fistula

Recognizing the symptoms of anal fistula is essential for prompt diagnosis and treatment. Ignoring these symptoms can lead to complications and a decrease in overall well-being.

  • Pain and discomfort: Individuals with anal fistulas often experience pain, especially during bowel movements or when sitting for extended periods. The pain may worsen with activity and can be sharp or throbbing.
  • Discharge: Another common symptom is the presence of pus or bloody discharge from the opening near the anus. This discharge may smell bad and stain undergarments.
  • Skin irritation: The skin surrounding the anal opening may become inflamed, red, and tender due to constant irritation from the discharge. It can cause itching, burning, and discomfort.

(Notes:) You should begin the treatment process with a doctor as soon as the symptoms appear.

Causes of Anal Fistula

Several factors can contribute to the development of anal fistulas. Understanding these causes can help prevent recurrence and manage the condition effectively.

  • Infection: Most of it develops as a complication of an anal abscess, which occurs when bacteria from the anal glands infect surrounding tissues.
  • Crohn's disease: Crohn's disease, a chronic inflammatory bowel condition, increases the risk of developing anal fistulas due to ongoing inflammation and tissue damage.
  • Previous anal abscess: Individuals who have previously experienced an anal abscess are at higher risk of developing an anal fistula, as the abscess may not heal properly, leading to the formation of a fistula tract.

Diagnosis of Anal Fistula

Diagnosing anal fistula typically involves a combination of physical examination, imaging tests, and possibly a colonoscopy to evaluate the extent of the condition.

  • Physical examination: During a physical exam, the healthcare provider will inspect the anal region for signs of inflammation, discharge, and other abnormalities.
  • Imaging tests: Imaging tests such as MRI or ultrasound may be ordered to visualize the fistula tract and assess its depth and direction.
  • Colonoscopy: In some cases, a colonoscopy may be recommended to rule out underlying conditions such as Crohn's disease or colorectal cancer.

Treatment options for Anal Fistula

Treatment for anal fistula aims to eliminate the fistula tract, promote healing, and prevent recurrence. The choice of treatment depends on the severity and location of the fistula.

  • Medications: Antibiotics and anti-inflammatory medications may be prescribed to control infection and reduce inflammation, especially in mild cases.
  • Fistulotomy: A fistulotomy is a surgical procedure that involves cutting open the entire length of the fistula tract to allow it to heal from the inside out.
  • Seton techniques: They involve placing a specialized thread or drain (seton) through the fistula tract to promote drainage and prevent closure while the surrounding tissues heal.
Anal Fistula Recovery and postoperative self-care

Recovery and postoperative self-care for Anal Fistula

Preventing anal fistulas involves addressing underlying risk factors and adopting healthy lifestyle habits. For uncomplicated fistula surgeries, expect a one-day hospital stay. Complex procedures may require 1-2 days. Follow post-surgical self-care instructions diligently.

  • Clean wounds with mild soapy water, rinse with tap water and pat dry with a clean cloth. Healing usually takes 4-6 weeks.
  • Use gauze or sanitary pads to prevent staining clothing from blood or discharge.
  • No dietary restrictions; eat normally, no need for soft foods.
  • After surgery, take laxatives or stool softeners as recommended by your doctor.
  • Your doctor may prescribe painkillers or antibiotics for additional medication.
  • Avoid driving for at least 2 days post-surgery.
  • Treat underlying conditions promptly.
  • Refrain from exercise or physical activities until cleared by your physician.
  • Regular medical check-ups.

Lifestyle changes and home remedies

In addition to medical treatment, certain lifestyle changes and home remedies may help alleviate symptoms and promote healing.

  • Dietary modifications: Eating a high-fiber diet and staying hydrated can help prevent constipation and promote regular bowel movements, reducing strain on the anal region.
  • Hygiene practices: Maintaining good hygiene, including gentle cleansing of the anal area after bowel movements and using mild, unscented soaps, can help prevent infection and irritation.
  • Sitz baths: Taking warm sitz baths several times a day can soothe the anal area, reduce inflammation, and promote healing of anal fistulas.

Complications of Anal Fistula

Without proper treatment, It can lead to various complications that may require additional medical intervention.

  • Recurrence: Anal fistulas have a high risk of recurrence, especially if the underlying cause is not addressed or if the initial treatment is not successful.
  • Abscess formation: Untreated anal fistulas can lead to the formation of recurrent anal abscesses, which can be painful and require drainage.
  • Anal stenosis: Chronic inflammation and scarring from anal fistulas can cause narrowing of the anal canal (anal stenosis), leading to difficulty with bowel movements.


Understanding anal fistula symptoms, causes, diagnosis, and treatment options is crucial in Bangladesh. It's worth noting that individuals in Bangladesh have access to expert care from Dr. Tariq Akhtar Khan, a highly experienced Colorectal and Laparoscopic Surgeon based in Dhaka.

With over 15+ years of expertise and a track record of over 500 successful surgeries, Dr. Tariq Akhtar Khan provides advanced treatment options, ensuring patients receive the highest quality care and optimal outcomes.

FAQ's regarding Anal Fistula

While some fistulas may close spontaneously, they often require medical intervention to prevent complications and promote healing.

Maintaining a high-fiber diet and staying hydrated can help promote regular bowel movements and reduce strain on the anal region, but individual dietary recommendations may vary based on specific needs.

Recovery time depends on the type of surgery performed and the individual's overall health. Most people can expect to return to normal activities within a few weeks to a couple of months.

Unfortunately, It has a high risk of recurrence, especially if underlying risk factors are not addressed or if the initial treatment is not successful.

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