Have you ever experienced a lump near your anus that frequently ruptures, oozes pus, and then reappears? This condition should not be dismissed as a simple boil. Recurring symptoms could be a sign of an anal fistula , a small, abnormal channel formed around the anus due to infection.
What is an anal fistula?
An anal fistula is an abnormal passage that forms between the inside of the anus or rectum and the skin around it. This condition usually begins with an infection or abscess (a collection of pus) around the anus that doesn't heal properly.
Once the canal has formed, the infection can recur, causing lumps and fluid to appear in the area around the anus.
Recognize the Symptoms of Anal Fistula
Some symptoms to watch out for include:
- A lump near the anus that appears and disappears repeatedly.
- Pus or fluid comes out of the lump around the anus.
- Pain or discomfort, especially when sitting or having a bowel movement (BAB).
- Wounds around the anus that don't heal.
- The skin around the anus becomes red or irritated.
- The complaint improved for a while, but then reappeared.
Who is at risk for anal fistula?
Anyone can develop an anal fistula. However, the risk is higher in people who have had an abscess or infection around the anus , especially if the infection didn't heal properly.
The risk may also increase in people with certain conditions, such as Crohn's disease or inflammatory bowel disease , as well as people who have had procedures or surgery on the anus and rectum.
Because the causes of lumps around the anus can vary, a doctor's examination is still necessary to determine whether the complaint is an anal fistula or another condition.
What Happens If Anal Fistula Is Left Untreated?
Anal fistulas generally don't heal permanently on their own . If left untreated, the fistula can become a source of infection and cause recurring symptoms.
Some problems that can occur include:
- Recurrent infections or abscesses , so that the area around the anus becomes swollen, painful, and discharges pus.
- Wounds that are difficult to heal , especially in the area where the fistula tract opens into the skin.
- Prolonged pain and discomfort , which can interfere with activities, sitting, and defecating.
- Formation of a more complex fistula tract , especially if the infection continues to recur.
- In certain conditions, complex fistulas can involve more tissue around the anal muscles, making treatment more difficult.
How is anal fistula treated?
Treatment of anal fistula depends on the location, shape, and complexity of the fistula , as well as the patient's overall health condition.
A general surgeon will first perform an examination to determine the most appropriate treatment option. Some possible treatments include:
1. Treatment of Abscesses or Infections
If there is an abscess or collection of pus, the doctor can take action to remove the pus (drainage) so that the infection can be resolved and complaints reduced.
Antibiotics may also be prescribed in certain circumstances, as recommended by a doctor. However, antibiotics alone generally do not eliminate the fistula tract once it has already formed.
2. Fistulotomy
Fistulotomy is a procedure often used to treat certain anal fistulas. In this procedure, the doctor opens the fistula tract so it can heal from the inside out.
This procedure is usually considered in fistulas whose path allows for opening without significantly disrupting anal muscle function.
3. Seton
In certain fistulas, especially those that pass through or near the muscles controlling the anus, the doctor may use a seton , which is a thread or special material placed through the fistula tract.
A seton can help keep the tract open and allow for proper drainage. Its use can be part of a staged treatment, especially for more complex fistulas.
4. Other Operational Procedures
For complex fistulas, doctors may consider other surgical techniques depending on the patient's condition. The goal is to treat the fistula tract while preserving anal muscle function .
Treatment options vary from patient to patient. Therefore, a thorough examination by a doctor is essential before deciding on therapy.
Don't be ashamed to seek medical treatment
Complaints around the anus often make people feel embarrassed or uncomfortable about seeking medical attention. However, anal health issues are medical conditions that require proper attention and treatment.
The longer it is left, the infection can recur and cause discomfort that interferes with daily activities.
The doctor will conduct the examination professionally and maintain the patient's privacy during the examination and treatment process.
When Should You See a Doctor?
Seek medical attention immediately if you experience recurring lumps around the anus, pus or fluid discharge, pain, or sores that do not heal .
A general surgeon can perform an examination to determine the cause of the complaint and determine appropriate treatment. In certain circumstances, additional tests may be necessary to determine the location and course of the fistula.
Article written by Dr. Rudy Haryanto Susilo, Sp.B (General Surgery Specialist, EMC Cibitung & Pekayon Hospital).