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Conditions

Anal Fistula

Anal fistula (Photo from Wellcome Trust)

No, this isn’t linked to the Queen’s ‘annus horribilis’ speech of 1992, but you only need to remove an ‘n’ from this phrase to be closer to the mark. An anal fistula is when a small, tunnel-like passageway forms between the anal canal and the opening to the outer skin surrounding the anus. A fistula usually develops after an anal abscess (a collection of pus) bursts, but can also form when an abscess has not been completely treated. They can also be caused by a condition which affects the intestines, such as irritable bowel syndrome (IBS) or Crohn’s disease. The unpleasant symptoms of an anal fistula may include: a throbbing, constant pain, irritation of skin around the anus, fever, evidence of pus or blood when passing stools, and generally feeling unwell. Pain also tends to worsen when you sit, move around, pass stools or cough. Unlike an anal fissure, most anal fistulas require surgery as they rarely heal untreated.

What the Men in White Coats Say

Comments and Questions

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I have been off work now since October 2009. I had intense pain for several weeks and then a huge lump appeared on the inside of my buttocks and I was rushed into hospital to have an abscess drained. They took 80 mls of pus out and left me with a big hole 10cm deep by 2.5cm diameter. This was packed daily and was almost healed but just wouldn't quite heal. So I was sent for an MRI scan. This showed that when my Abscess burst onto the surface it also tracked as a fistula into my bowel and pelvic floor. I then had another operation 0n 30th April to empty the abscess and put in a seton. The area was left open to heal and also it was packed because it tracked behind my annul sphincter. District Nurses came in daily to pack the wound and then it was left to me to do. I am still packing it daily and the treatement room nurse measures the wound weekly to see how it is healing. It seems to have stuck for the last 4 weeks and just will not heal over. I have a Seton thread coming out of my annus with a knot and it goes back in through another hole underneath my annus. It is very difficult to put in a dressing. Going for a bowel movement is a feat in itself because of this wire. I still bleed sllightly and I am also very sore where the setons rubs. My nurse has suggested putting a foam dressing on either side of the seton to stop the rubbing and this seems to be working. I have seen two GP's (second opinion) and neither of them will let me go back to work yet because I drive for a living and they say I could undo what I have had done. I am so fed up and embarressed everytime I tell my work. How long does it take for the seton hole to heal up ? How long will this rubbing go on for ? and what about sex ? This thing does not make me feel very feminine.





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my husband had his op on 29th sep 2009,he has a hole 41/2 centimetres deep still to this day there are no answers according to the surgeon. ,on his 5th day after his first surgery a d.nurse poked a bit hard and sent him reeling in agony 3 days later he was rushed to hosp with the nastiest infection ever and lost 3 1/2 stone in a week,since then we have had a nurde every day of our lives for the past 11 months if there is someone anyone who can give us an answer we would be grateful as we are to our wits end.thanx





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I have had what I thought was an anal fistula, buit after two recent ops they claim they couldnt find the source of the fistula. I have what seems to be a small lump near my anus which grows bursts an then bleeds for quite a while. Often as now there is a clear/greenish discharge (no smell). No real pain, but discomofrt and itching





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Thank you for visiting our web site and for discussing your problem so openly. If you would like the opportunity to be seen by one of the Embarrassing Bodies Doctors and have your problems assessed and treated by a specialist, then why not apply for the chance to take part in the programme. Please visit the following link and click ‘Apply to be on the show’ where you can fill in an application form: http://www.channel4embarrassingillnesses.com/features/be-on-embarrassing-bodies/

After a recent operation for an anal fistula, I receive a new dressing from a district nurse to plug the resultant wound-hole each morning shortly after I have opened my bowels. However, I frequently feel the urge (whether real or imaginary) to open my bowels again just a few hours later. This would immediately destroy the earlier dressing and I therefore try to resist going to the toilet until the next morning in order to receive the full 24-hour of the treatment. Am I right to do so? Meanwhile, if I was free to open my bowels from early morning through to about 4pm, I rather feel I would not wish to open my bowels again until the following morning. Would it make sense, therefore, to have the daily packing at 4pm when I would be fairly certain of it remaining in place - without stress - for the next 17 hours till 9am the next day (rather than for the current 24 hours with the dressing in place under some mental and physical distress)? Many thanks in anticipation of some helpful advice.





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I just had a seton/fistula operation done last week. Its in the anal region. I have learnt how to do the dressing myself before i left the hospital. I asked the nurse to give me a few weeks supply & its playing in my favour, rather then having to wait on someone else to do it for me. My advise is learn how to doit your self. Its only going to make you feel allot better especially when it comes to opening your bowels through the day.

this happens to my husband and has been for the past 11 months,so i have learned how to pack it every evening,his wont heal at all though,if you are stuck you have emergency nurses who can be called anytime day or night ...

Thanks Gary - I had a feeling that would be the only way. I have just moved house to a new area, so need to register with a new doc so will talk to him/her about the options. Could you tell me who your surgeon was? Would be great if I could be referred to a surgeon who has not messed this up before and can come recommended, even if this has to be through the private option. Am so nervous about incontinence...





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Hi, having had problems for 18 months, I thought I would share, as I remember how awful it was, until I started a series of surgeries. I just hope someone will feel some comfort and reassurance from my story. Feb 2009, out of the blue I felt a small mass , it felt as if something was blocking my anal canal. I took laxatives for a week and when there was no improvement, I went to the docs. I was prescribed laxatives and went away happy that I was going to have this sorted before any real pain occurred. Over the next 4 months, with numerous GP appointments and 2 visits to A & E, the pain was extraordinary, sometimes I could barely move. My GPs seemed helpless. The symptoms had increased to a deep throbbing in my buttocks, a feeling of huge pressure behind my sphincter, pus covered stools that were long and thin in shape, (the pain was also worse after I had opened my bowels, very fustrating when the pressure was not relieved!), feeling constantly unwell, and scared witless. My virginal passage had now closed up as well. These symptoms all fluctuated to a huge degree, but increased in severity. Eventually sent an appoiontment with Colorectal. By this time I was admitted to A & E, I could not stand or sit, I was unable to talk. I have had 8 or 9 procedures, under 2 hopitals in the last 14 months. I have had various seaton stitches in for almost a year, and also a mushroom tipped cathater for 6 months. The pain has varied,(I did not know there were so many different kinds of pain!), but generally has VASTLY improved with time. The seatons have been ok. No permanent inconntinence. The cathater was awkward to manage. And unpleasant. But a better option than having a cavity packed, I think. My life has changed a lot. I am recovering now, having had the cathater removed, the stitch replaced, the fistula excisced, a sphincter repair and an advancement flap. 9 days ago, and still pretty sore. But still, onwards and upwards eh? If you are reading this resource, and experiencing any of this, I hope you can find some comfort that you are not alone! My condition was severe and very complex, the most complex type of abscesses and the second most complex type of fistulae. And I WILL get better. And if you have had symptoms, GO to your doc. This condition does not get better without help.





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I developed a fistula after surgery. I had 11 surgeries last year and 2 already this year to repair it and then to repair the repairs. I have had an ileostomy and then a colostomy in order to give it a chance to heal but it is still there. Am now contemplating having the colostomy reversed and trying to live with the fistula but am terrified that I will get UTI's and further infections causing more fistulas.

hi im a 21 year old male and i have had what started as a blister at the top of my anus for 2 years now,everyday it leak`s a realy smelly puss wich some times can be seethrough and sometimes green and sometimes when i go to the toilet it bleeds i dont no if its coming from in my anus it seems to be coming out of this blister wich feels like a little hard ball now,can any body help





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I have 2 anal fissures and have had for a number of years. Sometimes pain and itch are manageable, other times it's as though I have sat on a red hot poker. The doc has prescribed a number of creams including Rectogesic, which causes mammoth headaches on usage. I now have Trimovate and I wanted to know whether this will make the situation worse by thinning the skin? Will it heal the fissures? I really don't want to go down the surgery route as faecal incontinence is far worse, but someone's thoughts would be appreciated. I have also heard that there is now botox treatment rather than surgery - is this true?





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I suffered for over a year with 2 fissures. I was in agony. I had botox, but this did not work. I then had the sphincterotomy as I was in so much pain, I had no option. The op was a total success and I have had no problems since. If your pain is as bad as mine, I recommend you go for surgery if other option fail.

i have trouble passing stools and have to press the bit of skin between my vagina and anus to go





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Hi, I'm a 20 yearl old male and for about 2 years now (it might even be longer I can't recall not having this problem actually) I've been suffering with a sore, itchy anus. There has been a 'discharge' as well, sometimes it is a clear like liquid that won't stop, on bad days it has soaked through to my jeans. Other times it is a very pale yellow-green greasy mucus like build-up. It smells bad and has been very embarrasing for me, it also itches more when the mucus is there and sometimes that is unbearable. There is blood coming from my anus too but only after I pass a stool (I have checked my stool and it contains no blood). I'm too embarrased to go to my doctor could somebody please help me. Thank you.





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I would go to the doctor asap, you would be surprised what they see everyday. You are just a human body to them nothing to be embarrassed about. or go straight to A&E when its bad and be seen by someone there.Must get it checked out though.

These problms are more common than people think. No body talks about them though so people suffer in silence. Your doctor will be able to help.People go to doctor with These sorts of problems every week.

Sounds to me like u have a perianal abcess,i had a build up like that and in the end the abcess burst and it absolutley stunk ,i also have blood coming from my anus,go to the doctors its very common ,and especially in men ,it wont get no better without going to see you gp,ive had surgery and now have what they call a fisula and awaiting surgery for that good luck .





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Content supplied by NHS Choices

An anal fistula is when a small, tunnel like structure (tract) develops between the back passage (anal canal) and the opening to the outer skin surrounding the anus. On the surface of the skin around the anus, one or more of the fistula ends may be seen as holes, which tunnel down into the back passage. Read More »

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