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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

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In the last year i have had 5 surgeries for anal abcess and horseshoe fistula..lots of pain,thought it was piles for long time so left it as long as possible but pain was so bad..at the time i never though i would get through this...a year it has all taken..i am a female and was very embarrassed talking about it...i hope i am over it even though i still need dressings on my wound as skin is so delicate...glad this has brought it out in open for people to understand more





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I was diagnosed with Crohns disease 30 years ago, 15 years later I had anal fistulas. I had many ops,but they didnt get any better. I was tranfered to a specialist hospital - I had further ops then put on a special treatment of 'Remicade', which I have every 8 weeks. I changed from a very sick person who couldnt work or do anything else, to a person who has a very physical job and live a very 'normal' life. I still have problems because I still have an illness, but I rule the illness it doesnt rule me. I even ran the 5km 'Race for Life', and Im doing it again this year. It took me along time to get here, so dont give up. Ask alot of questions, if your not happy about anything, tell the doctor, even if you want a transfer to a different hospital. At the end of the day its your body. I wish John all the very best and also my fellow sufferers x





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Why do you not put the answers to the questions below so we can read them I do have similar problems so I would like to see what you think? thanks ian





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hi i worried for around 6 months that i had piles, but it turned out to be anal warts . when i finally got the balls to go to doc. that was around 7 months ago. after usin ointment then cream and havin them frozen around 4 times they tell me this is not working so am now waiting on an appointment with a surgeon. but right now i am in pain, it hurts when i go for a poo and hurts a hell of alot more afterwards for around half an hr. i need to go back to the toilet and keep wiping as i think that the warts inside are stopping what happens naturally and not everything comes out at the same time. this is so unhygienic and uncomfortable and painful.





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hi i am 49 years old man with very itchy skin around the outside of the anus mainly at night just before goin to bed to apoint where scratching so hard plenty of blood but releif is great this hapens 3 to 4 times aweek have done this for about 20 yrs have used all kinds of creams from doctor and have had skin tests but with no sucsess curently using trimovate cream which works for a short time sometimes would be grateful if you can advise to get rid of this embarrassing problem thanks





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hi when i wipe my bum i sometimes have bits of blood on the toilet paper and it is sometimes very uncomfortable. just wondering if there is anything i can do?





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\i have this problems, with me its piles. check with your Doctor

hi a year ago i had an absess in the perineal area. after several months i had surgery for a pilodinal sinus. this meant taking 4 weeks off work. district nurses came for two weeks to pack the open wound. however it did not heal. my gp gave me penicillin type antibiotics which didnt work. the locum gp told me i didnt have a problem..it was piles! i had to be very insistent to see the consultant again. after 4 more months i saw the consultant who had a scan done. the scan was clear but i still had the absess. i refused to be discharged. they then examined me under anaesthestic when i woke up they told me that in fact i had a complex and high fistula and they had done a seton placement. that was 4 weeks ago. i have never experienced pain like this before. i was in bed for two weeks. the antibiotics for aneraobic organisms made me very ill so i couldnt swallow and became nauseated. cocodamal didnt work. the area then became infected and my gp prescribed penicillin. the consultant wouldnt see me. my gp sent me to a and e. a/e told me my gp should see me etc. they put me on ampicillin. next week the surgeon will be laying open the fistula. i am told i never had a piodinal sinus int he first place. apart from the pain and feeling very unwell i have missed many weeks of work and my job is now in jeopardy. all i can say is that people should be vry insistent and ensure they see a specialist as soon as possible if any absess forms. i believe the delay in being seen and being heard has caused me these serious complications. which could leave me incontinent. also be sure about tthe aftercare needed after this kind kind of surgery. you may not be able to drive, going to the loo will be painful and you need to buy in stocks to help you before and psychologically prepared. its hard to look after yourself after surgery. when in pain its hard to clean a wound you cant see, espcially when you can hardly move either. apart from the pain you may feel very unwell. finally this has caused havoc with my new relationship. its so embarassing that i would prefer my partner to move out and i havent told him the complete truth.





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like the person above 39 year old man, I have the same problem, (I am 42), inchy anus and sometimes bleeds, have it now for about 3-4 months. I use wet wipes after very toilet visit and shower every day. I have been using some creams for ichyness, with only mild releaf. also need some advise, Thanks.





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hi, i am a woman ages 52 I have been advised I have IBS but had a bad reaction to the powder mix they gave me before an endoscopy examination was due and so now didn't and not keen to go back! I have had the same as in the picture but thought it was just caused by acid and burning my skin around the anus area and didn't bother reporting it to my doctor. I am now off work AGAIN with a horrible pain in my left side! I have been given Colofac but they seem to be doing little to abate the pain after three days now. I think that it has started again after having antibiotics for an ear infection. Should I go back to the doctors and tell him the colofac is doing almost nothing and should I tell him I have had the same as in the picture?





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Hi! I have a very smelly anus, I shower loads and use baby wipes, it still smells really bad! There is a white discharge kind of sticky coming out! What can I do?





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It looks like no one else has asked this question, so please fill in the rest of your details below.





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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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