Causes and symptoms of anal fistula: When persistent discharge signals trouble
An anal fistula presents with persistent discharge, pain, intermittent swelling, foul smell, and irritation around the anal region. Symptoms often worsen during defecation. Recurrent infections may cause fever and weakness.
Persistent discharge near anus An anal fistula is commonly seen as persistent discharge of pus or serous fluid from an opening present near the anus. It may show multiple clinical features that usually worsen on defecation. Early identification and treatment can aid in preventing complications. (Images: Canva)
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Recurrent perianal pain episodes One of the most common features of anal fistula is recurrent and persistent pain around the anal region. When the internal opening gets blocked, there is a buildup of secretions. However, when the abscess (collection of pus) gets spontaneously drained, the person experiences a sense of relief.
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Continuous discharge and soiling Persistent discharge of pus or serous fluid from the external opening can soil the person’s undergarments, a common complaint of affected individuals. They may also notice intermittent swelling and pain, that worsens during defecation.
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Recurring swelling and lumps Perianal swelling or a tender lump that keeps appearing and receding is also a typical feature of anal fistula. This usually occurs due to an underlying abscess, and if left untreated, can cause fibrosis. Early drainage, hence, becomes necessary.
Itching due to moisture Pruritis ani refers to itching in the anal area, which is result of continuous discharge of pus. As the skin around the anal region remains constantly moist, it leads to skin excoriation and discomfort. Maintaining local hygiene may aid in reducing skin damage.
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Foul-smelling purulent discharge The discharge from an anal fistula is often foul-smelling, and is observed in people who have had long-standing fistulae, and it occurs because of infection by anaerobic organisms (organisms that do not need oxygen to survive). The nature of the discharge may aid in identifying the severity.
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Systemic signs of infection Other symptoms of anal fistulae include low-grade fever and generalised weakness, especially in people who have recurrent infections or abscess formation. It is essential to monitor the systemic signs so as to identify sepsis at an early stage. Prompt drainage of the abscess is hence necessary.
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Hygiene for symptom control Poor hygiene around the anal area is a risk factor that may worsen pre-existing symptoms. This can delay healing as well, and adequate attention should be paid to good hygiene practices. The area should be cleaned gently and harsh soaps must be avoided.
Smoking delays wound healing Smoking has also been known to delay wound healing, and must be avoided. Nicotine, present in cigarettes, can cause vasoconstriction and also reduce oxygenation in tissues. Cessation of smoking improves healing and may reduce the risk of developing complex fistula tracts.
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Early treatment prevents complications One of the best measures to prevent abscess around the anal region is early treatment. Incision and drainage can aid in avoiding the formation of chronic tracts. Early consultation with the healthcare provider regarding the symptoms can prevent complications. (Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis)
Rajeshwaari Kalla is a freelance health and wellness writer
