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What is an anal fistula?
Inside the anal canal are small glands that make mucus. Sometimes one of these glands gets blocked and infected, forming a pus pocket called a perianal abscess. When the abscess bursts or is drained, about one in three to one in two people are left with a narrow tunnel that stays open. That tunnel is a fistula-in-ano (भगंदर).
A fistula has an internal opening inside the anal canal and an external opening on the skin. Surgeons describe fistulas by how they relate to the sphincter muscles:
- Simple / low fistulas pass through little or no sphincter muscle. They are usually easier to treat.
- Complex / high fistulas pass through more muscle, have branches, several openings, or have come back after treatment. They need a more careful, muscle-sparing approach.
Symptoms of fistula
- A small opening near the anus that leaks pus, blood or fluid, often staining underwear
- Swelling and pain that build up, then ease when the fluid drains
- Itching or irritation of the skin around the opening
- Pain while sitting, walking or passing stool
- Repeated boils or abscesses in the same area
- Occasionally fever, if the tract gets blocked and infected again
Causes and risk factors
- A previous perianal abscess: the most common cause
- Diabetes, which makes infections more likely and slower to heal
- Crohn's disease (an inflammatory bowel disease)
- Tuberculosis: important to consider in India, especially with recurrent or unusual fistulas
- Previous anal surgery, radiation or injury
- Smoking and obesity, which slow wound healing
When to see a doctor
See a surgeon if you have a discharging opening near the anus, or a boil that keeps coming back. Get help urgently if you have:
- Fever with a hot, painful, growing swelling: this may be an abscess that needs draining
- Severe pain that stops you sitting or sleeping
- Difficulty passing urine along with anal swelling
- Diabetes with any of these signs: infections can spread faster
How a fistula is diagnosed at Samrijo
- Examination in a private room: the surgeon looks for the external opening and gently feels for the tract.
- Proctoscopy to look for the internal opening.
- MRI of the pelvis for complex or recurrent fistulas, to map the tract and any branches.
- Examination under anaesthesia (EUA), often done at the start of the procedure itself.
- Blood sugar and other tests at the hospital laboratory; tests for TB or Crohn's disease if suspected.
Treatment options
The right operation depends on the path of the tract. The surgeon's aim is to cure the fistula and protect bowel control.
Other techniques, such as advancement flaps, may be advised in specific cases. Your surgeon will explain why a particular option is suggested for you.
What to expect
Before
Examination, blood tests (including sugar), and MRI if needed. Any active abscess is drained first. The anaesthetist checks your fitness; you usually fast for about six hours.
During
Under anaesthesia, the surgeon confirms the path of the tract and performs the planned procedure. Many procedures take under an hour.
After
Many patients go home the same day or next day. Some discharge from the wound for a few weeks is normal. Sitz baths, dressings as advised, stool softeners and painkillers help recovery.
Follow-up
Regular check-ups make sure the wound heals from inside out. If a seton is in place, the next stage is planned at a follow-up visit. Recovery time varies by fistula type.
Living with a fistula until treatment
While you wait for your procedure, a few simple steps keep you comfortable and reduce flare-ups:
- Take warm sitz baths two or three times a day, and after passing stool.
- Wear soft cotton underwear, and use a small gauze pad to absorb discharge.
- Keep stools soft with fibre and water so you don't strain.
- If you have diabetes, keep your sugar under control: it makes a real difference to healing.
- Do not ignore a new, hot, painful swelling. It may mean the tract has blocked and an abscess is forming.
Why choose Samrijo Hospital for fistula treatment
- Sphincter-saving mindset: treatment is chosen to protect bowel control, not to fit one technique.
- Surgeon-led care by Dr. Arun Kumar Patel (MBBS, MS General Surgery).
- Laser and conventional techniques available, with an in-house operation theatre.
- In-house lab for sugar control and pre-procedure tests; 24×7 hospital for any concern after surgery.
Cost of fistula treatment
Cost depends on the type of fistula, the technique, whether the treatment is staged, anaesthesia, imaging such as MRI, length of stay and your insurance cover.
Call 93196 62944 for an estimate after your consultation.
भगंदर का इलाज, बुराड़ी, उत्तरी दिल्ली
भगंदर (फिस्टुला) गुदा के अंदर और बाहर की त्वचा के बीच बनी एक पतली सुरंग है। अक्सर यह गुदा के पास बने फोड़े (एब्सेस) के बाद बनता है। इसमें बार-बार मवाद या पानी निकलता है, सूजन आती है और बैठने में दर्द हो सकता है। डायबिटीज़, टीबी और क्रोहन रोग इसका ख़तरा बढ़ाते हैं।
भगंदर दवाइयों से अक्सर पूरी तरह ठीक नहीं होता; ज़्यादातर मरीज़ों को एक छोटी प्रक्रिया की ज़रूरत होती है। Samrijo Hospital, बुराड़ी में फिस्टुलोटॉमी, सेटन, LIFT और लेज़र जैसे विकल्प हैं। इलाज चुनते समय सबसे ज़्यादा ध्यान मल पर नियंत्रण रखने वाली मांसपेशियों को बचाने पर दिया जाता है। जटिल भगंदर में MRI जाँच की सलाह दी जा सकती है।
बुखार, तेज़ दर्द या बढ़ती सूजन हो तो देर न करें। कॉल करें: 93196 62944 (24×7)।
Frequently asked questions
Can a fistula heal with medicines alone?
Antibiotics can calm an infection for a while, but they rarely close a fistula tract permanently. Most anal fistulas need a procedure to heal. Your surgeon will explain the options that suit the type of fistula you have.
Is laser fistula treatment (FiLaC) suitable for everyone?
No. Laser closure works best for certain tracts and is less suitable for others, for example tracts with large side branches or active abscesses. Success rates vary between studies and some patients need a second procedure. MRI or examination under anaesthesia helps decide if it is right for you.
Will fistula surgery affect bowel control?
Protecting the sphincter muscle is a key goal of fistula treatment. For fistulas that pass through a lot of muscle, sphincter-saving methods such as seton, LIFT or laser are preferred. Every procedure carries some risk, which your surgeon will discuss with you.
Can a fistula come back after treatment?
Yes. Recurrence is possible after any fistula procedure, especially with complex tracts. Following wound-care advice, keeping stools soft and attending follow-up visits lowers the chance.
Do I need an MRI for a fistula?
Not always. A simple, low fistula can often be assessed by examination. An MRI of the pelvis is usually advised for fistulas that recur, have several openings, or seem to run deep, because it shows the tract and its branches clearly.
What does fistula treatment cost?
The cost depends on how complex the fistula is, the technique, whether more than one stage is needed, anaesthesia, stay and imaging. Call 93196 62944 for an estimate after a consultation.
भगंदर (फिस्टुला) क्या होता है?
भगंदर गुदा के अंदर और बाहर की त्वचा के बीच बनी एक छोटी सुरंग है। इसमें से बार-बार मवाद या पानी निकलता है और सूजन, दर्द या खुजली हो सकती है। यह ज़्यादातर पुराने फोड़े (एब्सेस) के बाद बनता है।
क्या भगंदर का लेज़र इलाज हो सकता है?
कुछ तरह के भगंदर में लेज़र से सुरंग को अंदर से बंद किया जा सकता है। हर भगंदर इसके लिए सही नहीं होता। जाँच और ज़रूरत हो तो MRI के बाद डॉक्टर बताएँगे कि आपके लिए कौन-सा इलाज बेहतर है।
Related treatments
This page is for general health information only. It is not a diagnosis or a substitute for a consultation. Every patient is different, so please consult a qualified doctor about your own condition and treatment. Medical disclaimer.