What Exactly Is an Anal Fistula and Why Does It Keep Coming Back

Introduction: The Hidden Pain Few Talk About

An anal fistula might sound like a small problem, but for those suffering from it, the pain, discharge, and constant discomfort can be unbearable.It’s not just a “minor infection” — it’s a chronic condition that often keeps returning even after temporary treatments.

Let’s understand what an anal fistula really is, why it develops, and most importantly — why it keeps coming back if not treated correctly.

What Is an Anal Fistula?

An anal fistula is an abnormal tunnel or tract that forms between the inside of the anal canal and the skin around the anus.

It usually develops after an infection in one of the anal glands (small glands near the anus) leads to an abscess — a pocket of pus.When that abscess drains or bursts, it leaves behind a channel connecting the infected gland to the outer skin.

So, instead of healing completely, it keeps leaking pus or fluid, causing pain, irritation, and swelling.

Common Symptoms of an Anal Fistula

If you’re experiencing any of these, it may be time to consult a specialist:

• Persistent pain or swelling near the anus

• Discharge of pus or blood from a small opening near the anus

• Recurrent abscesses (boils that keep coming back)

• Irritation or itching in the anal region

• Fever or fatigue (if infection spreads)

• Pain during sitting, bowel movements, or even walking

These symptoms may worsen over time and can affect daily comfort and hygiene.

Why Does an Anal Fistula Develop?

The main cause is infection in the anal glands, but several factors increase the risk:

• Untreated or recurrent anal abscesses

• Inflammatory bowel disease (IBD) such as Crohn’s disease

• Tuberculosis or trauma in rare cases

• Prolonged constipation or straining during bowel movements

• Poor hygiene or diabetes, which delays healing

Once the infection burrows deep into tissues, it forms a persistent tunnel that doesn’t close on its own.

Why Does It Keep Coming Back?

This is one of the most frustrating parts for patients — even after drainage or temporary healing, the fistula often recurs. Here’s why:

1. Incomplete Treatment of the Tract

If only the abscess is drained and the internal tract is not removed, the infection pathway remains — causing recurrence.

2. Hidden Internal Opening

Even if the outer wound looks healed, a small internal opening inside the anal canal can keep re-infecting the area.

3. Incorrect Diagnosis or Procedure

Each fistula is different (simple, complex, high, or branching).Using a one-size-fits-all approach can leave parts of the tract untreated.

4. Infection or Poor Wound Healing

Conditions like diabetes or poor immunity delay healing and promote reinfection.

5. Lifestyle and Hygiene Factors

Ignoring post-surgery care, improper cleaning, or prolonged sitting may contribute to recurrence.

Modern Treatment Options for Anal Fistula

Gone are the days when fistula surgery meant long recovery and painful dressing.Today, advanced and minimally invasive options are available:

✅ 1. Laser Fistula Surgery (FiLaC or Laser Ablation)

• A laser fiber is used to close the fistula tract from inside.

• Minimally invasive, painless, and fast recovery.

• Reduces recurrence rates significantly.

✅ 2. VAAFT (Video-Assisted Anal Fistula Treatment)

• Uses a small camera to visualize the fistula from inside.

• Allows precise removal of the tract while preserving sphincter muscles.

✅ 3. Fistulotomy (Traditional Surgery)

• Suitable for simple or low fistulas.

• The tract is opened and allowed to heal naturally.

✅ 4. LIFT Procedure (Ligation of Intersphincteric Fistula Tract)

• A sphincter-sparing surgery ideal for complex fistulas.

• Targets the internal connection directly to prevent recurrence.

Each case is unique — your surgeon decides the best approach based on MRI or fistulogram results.

Recovery & Aftercare Tips

• Maintain proper anal hygiene and keep the area dry.

• Take sit baths with warm water to soothe and clean the area.

• Follow a high-fiber diet to avoid constipation.

• Drink plenty of water and use stool softeners if prescribed.

• Avoid long sitting hours; use a soft cushion if needed.

• Attend follow-up appointments regularly.

Proper care ensures faster healing and lowers recurrence risk.

Can an Anal Fistula Heal Without Surgery?

Unfortunately, no — once a fistula tract forms, it rarely heals on its own.Temporary relief from antibiotics or ointments only reduces symptoms but doesn’t close the internal connection.Surgery or laser treatment remains the only permanent solution.

Conclusion: Early Action Leads to Complete Cure

An anal fistula is not just a skin infection — it’s a tunnel that requires expert surgical care.Ignoring it or delaying treatment only increases the risk of recurrent infections and long-term complications.

The good news?With modern laser and minimally invasive procedures, patients recover quickly — pain-free, scar-free, and stress-free.

👉 If you’ve been struggling with recurring boils or pus discharge near the anus, consult Dr. SaurabhBansal.