An anal abscess is an infected cavity near the anus or rectum. An anal fistula is usually derived from patients who have had an abscess. A fistula is a small tube or tunnel which connects the skin and the previous abscess site.
An abscess is usually secondary to an acute infection in the glands which are near the anus. Inflammatory bowel disease can also predispose a patient to abscess formation. In addition, fistulas are associated with inflammatory bowel disease.
Persistent infection usually results in a fistula in patients who do not have underlying inflammatory bowel disease.
Most patients present with constant pain associated with swelling, fevers, chills and episodes of sweating. Drainage of pus, associated with improvement in the pain, is not uncommon. It is important to understand that anorectal abscesses do not always develop into fistulas.
The treatment of a fistulous tract is associated with treatment of an abscess. Abscesses usually require an incision and drainage by a surgeon. Patients may require hospitalization for some drainage procedures. Antibiotics are utilized in conjunction with an incision and drainage procedure.
Treatment of a fistula is usually surgical in nature. Patients usually do well with a surgical excision of the fistula. However, this procedure should be performed by a colorectal surgeon or a surgeon who has significant experience in performing this type of procedure.
Recovery from a fistulectomy (surgical removal of the fistula) can take several weeks or months. In most cases, treatment after the surgery includes sitz baths as well as perirectal hygiene measures. Specific interventions will be provided by your surgeon.
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