What is an Anal Fistula?
Anal Fistula Common Signs & Symptoms
You might notice:
• Pain or throbbing around the anus — especially when sitting, walking, or pooping
• Swelling or a tender lump near the anus
• Pus, smelly discharge, or even a bit of blood leaking from a small hole near the anus (clothes or underwear might get stained)
• Red, itchy, or irritated skin around the area
• Sometimes fever, tiredness, or feeling unwell if infection flares up again
These symptoms often come and go — the area might feel better for a while, then get bad again when a new abscess forms.
Why Does It Happen?
Almost all anal fistulas come from an infected anal gland (tiny glands inside the anus that sometimes get blocked and infected).
Other things that raise the chance:
• Previous anal abscess that wasn’t fully cleared
• Crohn’s disease or other bowel inflammation conditions
• Long-term diarrhea or certain infections
• In rare cases, injury, surgery, or radiation in that area
It’s more common in men, but anyone can get it.
How Is It Treated?
Fistulas almost never heal by themselves — waiting usually makes things worse with more pain and repeated infections.
Doctors usually recommend treatment, and most people need some kind of procedure.
Mild / Non-Surgery Options (used in some cases, especially to control infection first):
• Antibiotics → only help if there’s active infection, but won’t close the tunnel
• Keeping the area clean, warm baths (sitz baths), and pain relief
Main Treatments (usually surgery or procedures): Most fistulas need a procedure to fix the tunnel properly.
Anal Fistula Common options
• FistulotomyThe surgeon opens the whole tunnel so it can heal flat from the inside out.Very effective, but used more for simpler fistulas because it can affect muscle control if the tunnel is deep.
• LIFT procedure (Ligation of Intersphincteric Fistula Tract)A gentler method — the surgeon finds the tunnel between the sphincter muscles (the muscles that help you hold poop), ties it off, and closes it.Good for preserving muscle strength and avoiding leakage problems.
• Laser treatment (like FiLaC — Fistula-tract Laser Closure)A modern, less invasive option.A thin laser fiber goes into the tunnel and uses heat to gently seal and close it from the inside.Usually means less pain afterward, quicker healing, and lower risk to the muscles that control bowel movements.
The best choice depends on where the fistula is, how complex it is, and your overall health. A colorectal surgeon (specialist in bottom-area problems) will check with an exam (sometimes under anesthesia) or imaging and suggest what’s safest for you.
Here is a simpler, easier-to-understand version of your article that is suitable for communicating with the general public.
Yongsun Wongwiwatseree, M.D.
Colorectal & Haemorrhoid Clinic, Surgery Department
Specialty
General Surgery,Colon and Rectal Surgery
Language
Thai, English
Laparoscopic Surgery
– Diplomate, Thai Board of Colon and Rectal Surgery, 2002
– Diplomate, Thai Board of Surgery, 1999
– Clinical Fellowship in Colon and Rectal Surgery Chulalongkorn University, 2002
– Residency in General Surgery, Chulalongkorn University, 1999
– MD. Chulalongkorn University, 1993
Doctor’s Schedule
| Day | Time | Location |
|---|---|---|
| Monday | 09:00 – 17:00 | Colorectal & Haemorrhoid Clinic, Surgery Department |
| Tuesday | 09:00 – 15:00 | Colorectal & Haemorrhoid Clinic, Surgery Department |
| Wednesday | 11:00 – 16:30 | Colorectal & Haemorrhoid Clinic, Surgery Department |
| Thursday | 09:00 – 17:00 | Colorectal & Haemorrhoid Clinic, Surgery Department |
| Sunday | 09:30 – 12:00 | Colorectal & Haemorrhoid Clinic, Surgery Department |
