Anal Fistula

Common Symptoms of Anal Fistula

• Persistent pain or throbbing near the anus
• Swelling or redness around the anal area
• Discharge of pus or blood from a small opening near the anus
• Irritation and itching around the area
• Recurrent abscesses or infections
• Fever or malaise, especially if infection is active

If you have a draining abscess or ongoing discomfort, it’s important to see a Proctologist or General Surgeon or Colorectal surgeon immediately for evaluation. You might need emergency surgery!

What Causes Anal Fistulas?

Most anal fistulas start as nonspecific infections of small glands inside the anus. Other causes include:

• Anorectal abscesses that fail to heal completely
• Crohn’s disease or ulcerative colitis (inflammatory bowel diseases)
• Trauma
• Foreign body
• Episiotomy / Obstetric injury during delivering a child
• Previous surgery or trauma in the anal region
• Tuberculosis or sexually transmitted infections (less common causes)
• Malignancy
• Radiation

How to diagnose: physical examination, anoscopy/rectoscopy, endoanal ultrasound, MRI

Treatment Options for Anal Fistula

Anal fistulasdo not heal on their own and they require surgical management. Treatment depends on the fistula’s complexity and location (“low “or “high” anal fistula), and may include:

• Minimally invasive sphincter-preserving anal fistula repair
• Minimally invasive Laser anal fistula closure (FiLaC)
• VAAFT: Video-Assisted Anal Fistula Treatment
• EAF: Endorectal Advancement Flap procedure
• LIFT: Ligation of the Intersphincteric Fistula Tract procedure – this is also a sphincter preserving technique used in certain types of fistulas
• Fistulotomy or “lay-open technique”: opening the tract and allowing it to heal naturally
• Seton placement for complex cases: a medical thread used to keep the tract open for drainage before definitive closure
• Fibrin glue, biological injectables (eg.: Permacol) plug therapy

At Mubadala Health Dubai, our multidisciplinary team of general surgeons and gastroenterologists uses modern, minimally invasive techniques to ensure safe and effective recovery.

When to See a Doctor

Consult a doctor or go to Emergency if you have:

• Persistent pain, swelling, or pus discharge near or from the anus – You might need emergency surgery in case of perianal abscess!
• Signs of infection or fever
• Bleeding
• A history of abscesses or Crohn’s disease