An anal fistula is an abnormal connection between the inside of the anal canal and the skin around the anus.

A fistula usually arises as a consequence of an infection of one of the glands that are located within the anal canal. Bacteria that are normally present in the anal glands begin to multiply and form an abscess that burrows through the wall of the rectum and to the skin surrounding the anus. Some abscesses will rupture or break open spontaneously. Others will require surgical drainage. A fistula develops when the tract that extends between the inside gland and the outside opening does not heal.

While most fistulas are caused by infection, some are caused by cancer, trauma and Crohn’s Disease . Women can sometimes develop fistulas between the rectum and the vagina after childbirth. This usually results from failure of an episiotomy to heal.

Symptoms of anal fistulas include pain, bleeding, recurrent anal infections, soiling with pus or blood.

The treatment of anal fistulas is usually surgery. The type of surgery is dependent on the location of the fistula and its complexity. Surgery is usually accomplished at an outpatient surgicenter under a local, general or spinal anesthetic.