The anal canal contains small glands that open into its lining. If one of them becomes inflamed, the inflammation can spread into the surrounding tissue. If pus collects there, an anal abscess forms: an encapsulated inflammation that usually causes rapidly increasing, throbbing pain, often with swelling, redness and sometimes fever.
As a rule, an abscess does not heal on its own and is therefore opened surgically without delay. The pressure usually eases noticeably afterwards. In some of those affected, however, a connection remains between the inflamed gland and the skin – a fine tract, the anal fistula. It often shows itself as a small opening next to the anus from which a little fluid leaks again and again, or as recurring inflammation in the same place.
A fistula does not close permanently by itself. Because its tract often runs through parts of the sphincter muscle, the operation calls for particular care: it should close the tract while preserving continence, that is, the reliable function of the sphincter muscle. Which procedure is suitable depends on the exact course of the tract.
If fistulas keep coming back or take an unusual course, a chronic inflammatory bowel disease such as Crohn’s disease is also considered. Surgery and gastroenterology then coordinate the treatment.
Maksims Margolins
Dr. med. Gerhard Schüder
Rangel Shahanski
Mohamad Shalabi
