An anal fistula is a tunnel that runs from inside the anus -- the hole your body uses to get rid of solid waste -- to somewhere in the skin around it. It usually follows an infection that didn’t heal the right way. Your doctor can repair the fistula, but you'll need surgery for that.
What Causes It?
Just inside your anus are several glands that make fluid. Sometimes, they get blocked or clogged. When that happens, a bacteria buildup can create a swollen pocket of infected tissue and liquid. Doctors call this an abscess. If you don’t treat the abscess, it’ll grow. Eventually, it’ll make its way to the outside and punch a hole in the skin somewhere near your anus so the gunk inside it can drain. The fistula is the tunnel that connects the gland to that opening. Most of the time, an abscess causes a fistula. It’s rare, but they can also come from conditions like tuberculosis, sexually transmitted diseases, or an ongoing illness that affects your bowels.
The most common ones are:
If the doctor thinks you have an anal fistula, she’ll ask about your medical history and give you a physical exam.
Some fistulas are easy to spot. Others aren’t. Sometimes they close on their own, then open back up. Your doctor will look for signs of oozing fluid or bleeding. She might stick a finger into your anus during the exam.
She’ll probably send you to a specialist in colon and rectal problems for more exams or imaging tests like X-rays or a CT scan. You might even need a colonoscopy. For this test, the doctor will put a tube with a camera on the end into your anus to look at the inside of your bowels. You’ll be asleep when this happens.
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