Anal Fistula Overview
An anal fistula is an abnormal tunnel or connection between the anal canal (inside the rectum) and the skin around the anus. It often develops as a complication of a previous anal abscess, where infection from a blocked anal gland creates a pocket of pus that drains — but leaves behind a channel that doesn’t heal on its own.
Painful Complications
Anal fistulas are painful and persistent, often causing discomfort, swelling, and recurring drainage of pus or blood. The condition is more common in men, people with Crohn’s disease, and those with a history of anal abscesses.
In South Africa and globally, fistulas are often misdiagnosed as haemorrhoids or skin infections. However, they require very different treatment, usually involving surgery to remove or open the tract so it can heal properly.
Common symptoms include:
- Pain near the anus, especially when sitting or passing stool
- Swelling or a visible opening on the skin
- Persistent or intermittent discharge of pus or blood
- A foul smell or irritation around the anus
- Fever, in some cases of infection
While not life-threatening, untreated anal fistulas can cause serious discomfort and repeated infections. In the next section, we’ll explore what causes them and who is most at risk.