An anal fistula usually occurs as the result of a previous anal abscess. An anal abscess occurs when the anal gland becomes clogged and infected, causing the cavities to fill with pus near the anus or rectum. The anal fistula commonly connects the previously infected anal gland with the skin of the buttocks, according to the American Society of Colon and Rectal Surgeons. In women, it is possible for women to develop a fistula from the anus to the vagina.
Causes
After a physician drains an anal abscess, a tunnel may still exist connecting the anal gland where the abscess had occurred and connecting it to the skin. The American Society of Colon and Rectal Surgeons explain that even if the opening of the tunnel heals at the skin, the fistula may still exist and recurrent abscesses may develop. An anovaginal fistula may occur due to trauma.
Causes
People with an anal fistula will most often experience rectal pain and irritation of the skin around the anus. Patients may notice pus or blood either seen during bowel movements or seeping from an opening of the buttock, according to the Merck Manual of Geriatrics. The MayoClinic.com explains that in an anovaginal fistula, women may notice foul smelling vaginal discharge, recurrent vaginal or urinary tract infections, pain during sexual activity, passage of gas, stool or pus from the vagina and irritation or pain in the vagina and outer tissues.
Risk Factors
People are at greater risk for an anal fistula if they have a previous history of anal abscess. People with inflammatory diseases such as Crohn's disease or tuberculosis have a greater risk of developing an anal fistula, according to the Merck Manual of Geriatrics. Women who suffer vaginal or anal trauma may be at greater risk for anal fistulas.
Treatments
In order to treat an anal fistula, patients must undergo surgery. Fistula surgery commonly involves opening the fistula and inverting it so that it may heal from the inside out. Surgeons often can perform the surgery on an outpatient basis. Treatment of extensive anal fistula's often require a short hospital stay, according to the American Society of Colon and Rectal Surgeons.
Recovery
The American Society of Colon and Rectal Surgeons explains that patients may experience mild to moderate discomfort in the seven days following surgery. Physicians will often prescribe pain pills in order to help with the discomfort. Patients may also receive stool softeners to help with bowel movements as they recover from surgery.
