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- Increased 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
- Malaise—a general feeling of discomfort
- 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 are 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 November 18, 2013.
Anal fistula. John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/digestive%5Fdisorders/anal%5Ffistula%5F134,173/. Accessed November 18, 2013.
Anal rectal abscess & fistula. Hemorrhoid website. Available at: http://www.hemorrhoid.net/abscess.php. Accessed November 18, 2013.
Fistula-in-ano. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated October 26, 2012. Accessed November 18, 2013.
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: Marcin Chwistek, MD
- Review Date: 01/2014