General Surgery in Lagos
Anal Fistula
The signs, what causes it, and when to see a general surgery specialist in Lagos.
Signs to look for
Anal Fistula
- A small opening in the skin near the anus that leaks pus, blood or stained fluid
- Pain and swelling near the anus that builds up and eases when it drains
- Staining of underwear, with itching or soreness of the skin around the anus
- A lump near the anus that bursts and keeps coming back
- Pain when sitting, walking or opening your bowels
An anal fistula is a small tunnel between the inside of the back passage and the skin near the anus. Most start as an anal abscess, a collection of pus beside the anus, that burst or was drained but did not heal fully from the inside. It is often called piles in Nigeria, but it is a different condition: pile creams, herbs and enemas do not close it, and it is treated with an operation. Most fistulas are cured by one planned operation, chosen to protect the muscle that controls the bowel. Crohn's disease, tuberculosis and HIV sit behind some fistulas, especially ones that keep coming back, which is why a surgeon examines carefully before operating.
Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- A small opening in the skin near the anus that leaks pus, blood or stained fluid
- Pain and swelling near the anus that builds up and eases when it drains
- Staining of underwear, with itching or soreness of the skin around the anus
- A lump near the anus that bursts and keeps coming back
- Pain when sitting, walking or opening your bowels
- Fever and feeling unwell when the tunnel blocks and an abscess forms again
When to See a Doctor
See a doctor if an opening near the anus keeps leaking, or a painful swelling there has burst and come back. A fistula does not heal on its own, and the earlier a surgeon examines it, the simpler the operation tends to be. Go to hospital the same day for a hot, painful swelling near the anus with fever, which is an abscess and needs draining, and sooner still if you have diabetes. See a doctor promptly if a fistula comes with diarrhoea, weight loss or blood mixed into the stool.
Treatment options
- Examination by a surgeon, sometimes with an MRI scan or an examination under anaesthetic to map the tunnel
- Draining any abscess first, so the infection settles
- Fistulotomy, which lays a low tunnel open so it heals from the base
- A seton, a soft thread passed through the tunnel to drain it and protect the muscle, often as the first of two stages
- Muscle-sparing operations, such as an advancement flap or LIFT, for a fistula that crosses more of the sphincter muscle
- Treatment of an underlying cause, such as Crohn's disease or tuberculosis, where tests find one
What it costs on Mezo
Starting cash prices for the treatments used for this condition.
Common Questions
Is an anal fistula the same as piles?
No. Piles are swollen blood vessels. A fistula is a tunnel that leaks pus or fluid onto the skin near the anus, usually after an abscess. Both can bleed or cause discomfort, which is why they are confused, but the treatment is different. A surgeon can usually tell them apart on examination.
Can a fistula heal without surgery?
Almost never. Antibiotics can calm the infection for a while, but the tunnel stays and the swelling comes back. Creams, herbs and enemas sold for piles do not close it.
Will fistula surgery affect my bowel control?
Protecting the muscle that controls the bowel is the surgeon's first concern. For a simple, low fistula the risk is small. Where the tunnel crosses more of the muscle, a seton or a muscle-sparing operation is used instead, and the surgeon explains the risk before you agree.
Can a fistula come back after surgery?
Sometimes, particularly a complex fistula or one with an underlying cause such as Crohn's disease. Keeping every follow-up appointment lets the surgeon check that the wound has healed from the base.
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General Surgery in Lagos →General Surgery in Abuja →General Surgery in Port Harcourt →General Surgery in Jos →General Surgery in Ibadan →Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.