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- Increases with bowel movements
- More likely with infection
- Persistent drainage of pus or blood through the opening in the anal skin
- Swelling, soreness, or itching around the anal skin
- Fever or chills
- Feeling tired and sick
- Anoscopy—examination of the anal canal with a scope
- Probe—a thin, small probe may be inserted into the anal skin to see if a channel is present and where it leads
- CT scan
- Fistulotomy—A trench is created in the fistula, which allows for healing from the inside out.
- Sealant or plug—A substance is used to fill in the fistula. Both ends of the fistula are closed off, allowing it to heal.
- Endorectal flap—A flap is created to expose the internal opening of the fistula. The fistula is stitched shut, and then the flap is put back into place.
- Ligation of intersphincteric fistula tract (LIFT)—The internal part of the fistula is identified and tied off. Any infected glandular tissue in the anal canal is removed and the fistula is stitched at the external opening.
- Fistulectomy—Rarely done, the fistula is completely removed.
American College of Gastroenterology http://gi.org
American Society of Colon and Rectal Surgeons http://www.fascrs.org
Canadian Association of Gastroenterology http://www.cag-acg.org
Capital Health http://www.cdha.nshealth.ca
Abcarian H. Anorectal infection: Abscess-fistula. Clin Colon Rect Surg. 2011;24(1):14-21.
Anal abscess/fistula. American Society of Colon & Rectal Surgeons website. Available at: http://www.fascrs.org/patients/conditions/anal%5Fabscess%5Ffistula. Updated October 2012. Accessed December 16, 2014.
Anal fistula. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/digestive%5Fdisorders/anal%5Ffistula%5F134,173/. Accessed December 16, 2014.
Fistula-in-ano. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 26, 2012. Accessed December 16, 2014.
Rojanasakul A. LIFT procedure: a simplified technique for fistula-in-ano. Tech Coloproctol. 2009;13(3):237-240.
van Onkelen RS, Gosselink MP. Is it possible to improve the outcome of transanal advancement flap repair for high transsphincteric fistulas by additional ligation of the intersphincteric fistula tract? Dis Colon Rectum. 2012;55(2):163-166.
- Reviewer: Michael Woods, MD
- Review Date: 12/2014 -
- Update Date: 12/20/2014 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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