We classify anal fistulas by their location to anal sphincter muscles, such as the following:

• Inter-sphincteric Anal Fistula: Between your internal and external sphincter muscles
• Trans-sphincteric Anal Fistula: Travels through both layers of anal sphincter muscles
• Supra-sphincteric Anal Fistula: Passes through your internal sphincter and goes around the external sphincter
• Extra-sphincteric Anal Fistula: Goes around both sphincter muscles
• Superficial Anal Fistula: Travels from the lower part of the anal canal, and bypasses muscles.

The surgery for anal fistulas, also known as fistulotomy, involves cutting along the whole length of the fistula to open it up. This makes it an open scar that heals as a flat muscle.

After the fistula surgery, the pain and swelling in the anal area will vanish. You will have painless bowel movements, and notice a reduction of anal abscesses.

The treatment for anal fistulas carries several risks, such as infection from the course of antibiotics. If the severity rises, the case needs to be treated in hospital. There can also be episodes of recurrence of the fistula.

After the fistula operation, the patient can go home as soon as the effect of the anesthetic wears off. You will be able to pass urine and can be comfortable in eating and drinking. Since we employ a general anesthetic, a responsible adult must accompany you home and stay with you for 24 hours. Before discharge, you will be advised about post-operative care, as well as the painkillers and laxatives.

Most times, fistula surgery is successful if proper care is taken with operational preparations. Yes, fistula can recur multiple times post-operations also. One must take corrective measures to prevent the development of the fistula in the anal canal.

The healing will not last more than a few hours. You can start drinking water shortly after the procedure and start eating when hungry. You can get out of bed a few hours after surgery. With some pain after the procedure, we can control it with painkillers. A small amount of bleeding is expected, so wearing a pad will protect your clothes from getting soiled.

Yes, you can within a day.

Any responsible hospital will make you go through a prior consultation of your health condition before suggesting surgery. If you have any other concerning issues, then you can share them with the surgery team at Atharva Hospital, and we will take the necessary course of action for you.

Fistula is an abnormal passage between a hollow or tubular organ and the body surface, or between two hollow or tubular organs, particularly around the anal region. It is different from piles and fissures in the sense that fistulas are an opening of the anal cavity with pus discharging out of it.

No, the fistula needs to be treated properly with medication, ointment application, or in some cases, surgery.

Some of the symptoms of fistula development are swelling coming out of the anal opening, a sense of incomplete evacuation after a bowel movement, constipation, Pain in the rectal region, and ulcerated causing bleeding.

There are no such effective home remedies for fistula treatment. Our advice would be not to fall for such half-cooked information, as it can be further detrimental to your health.

The doctor, depending on the severity of the condition, may suggest ointment application, and medication for the fistula treatment, in case he thinks that surgery might not be eminent in your case.

An untreated fistula can cause mundane complications such as drainage, sepsis, perforation, and even peritonitis. It is not a life-threatening condition but can trigger serious complications.

Yes, patients suffering from Fistula are suggested to drink plenty of water and eat foods rich in fiber, which supports your system in wound healing.

Antibiotics play a major role in the treatment of anal fistulas for patients with systemic symptoms. We also suggest postoperative prophylactic antibiotic therapy for 7-10 days for preventing anal fistulas after incision and drainage of perianal abscess.

Any individual facing the symptoms of anal fistula, like inflammation around the anal opening, fever, or pain in the rectum and anus, should immediately consult a qualified proctologist.

An anal fistula tunnel develops between the end of the bowel and the skin near the anal opening. Usually caused by an anal infection, fistula results in a collection of pus in the nearby tissue. Depending on the severity of the condition, a doctor can suggest a fistula surgery.

Anal fistula surgery can be simple or complex, depending on the fistula. The most common anal fistulas are simple, inter-sphincteric fistulas, involving a small amount of muscle. Different surgical techniques employed to treat anal fistula treatment:

• Simple Fistulas: For anal fistula involving a minimal amount of muscle with no branches
• Fistulotomy: A colorectal surgeon will cut through the roof of the fistula, which means cutting through a small amount of muscle
• Complex Fistulas: It involves a significant amount of muscle with branches or preexisting conditions raising your risk of surgical complications
• Endorectal Advancement Flap: This procedure avoids cutting into the roof of the fistula to keep your sphincter muscles intact.
• LIFT procedure: It is the Ligation of the Inter-sphincteric Fistula Tract, which means closing the part of the fistula that passes between two sphincter muscles usually with stitches.

Fistulotomy is the most common type of surgery for anal fistula. It involves cutting the whole length of the fistula to open it up and heal it as a flat scar. A fistulotomy is the most effective treatment for many variations of anal fistulas.

Over 95% of success rate is boasted by the Atharva Hospital in the anal fistula surgery.

The potential complications associated with anal fistula surgery are:

• Recurring Infection: If the infection isn’t completely gone from your fistula, it may continue inside your healing fistula
• Recurring Fistula: Anal fistula may come back after surgery if not healed completely
• Fecal Incontinence: You may experience slightly compromised fecal continence after the fistula surgery

For mobility, you can pad over the opening of the fistula to absorb the drainage. Most people can go back to their normal routine within one to two weeks of surgery. It might take several weeks to months for your fistula to completely heal.

Yes, they can if the fistula has not been completely removed or if there is still infection in the area.

In a minimum of two to three weeks

There are no long-term implications of anal fistula surgery. Although, the complete healing may require 3-4 months.

If the medications and other corrective measures are rendered ineffective and the symptoms get severe with time.

No, anal fistulas require proper treatment with medications, dietary restrictions, and in some cases operational surgery.

The common symptoms of fistula development are swelling out of the anal opening, a sense of incomplete evacuation, constipation, pain in the rectal region, and ulceration causing bleeding.

There is no such treatment as conservative for anal fistulas. Although a non-surgical option, the fibrin glue treatment can be considered a traditional option. It involves injecting glue into the fistula under a general anesthetic.

It becomes imperative in case the medication and other non-surgical options prove ineffective.

Antibiotics for the infected area around your fistula, and Infliximab or Remicade to reduce inflammation and heal fistulas

You are at a risk of developing cancer in the fistula tract if it is left untreated for a long period.

The success rate is higher for surgical treatment at a whopping 95%.

Fistula procedures are generally outpatient procedures. Post-surgery, you will have prescription pain medication to take home with you, along with some instructions for self-care, which may include:

• Water and fiber supplements
• Sitz bath
• Wound management with dressings to collect drainage

It’s like taking a small nap! All you will feel is a small needle prick during your preparation for the procedure. The entire surgery takes about 30 minutes.

You will normally be able to start drinking water shortly after the procedure and can start eating as soon as you are hungry. You will be able to get out of bed a few hours after surgery. You are likely to have some pain after the procedure that is easily controlled with painkillers. You can expect a small amount of bleeding and wearing a pad will protect your clothes from getting soiled.

If your operation is planned as a day care procedure you can go home as soon as the effect of the anaesthetic has worn off, you have passed urine and you are comfortable, eating and drinking. Since a general anaesthetic is used, it is advisable that a responsible adult take you home and stay with you for 24 hours.Before you are discharged you will be advised about post-operative care, painkillers and laxatives.

You will normally open your bowels within 2-3 days of your operation. This may be uncomfortable at first and there could be a sense of ‘urgency’ (need to rush to the toilet). You may notice mild blood loss after each bowel movement but this will gradually reduce over the next few days. Maintain hygiene, and wash and keep the operation site clean. It is important to maintain a regular bowel movement that should be well formed but soft. You may need to take prescribed laxatives for 2-4 weeks. Eating a high fibre diet and increasing water/fluid intake will help.

• If you develop a fever above 100 F
• Increasing pain, swelling, redness or discharge
• Severe bleeding
• Constipation >3 days