Anal fistula: Symptoms, diagnosis and treatment

Written in association with: Mr Anwar Ahmad
Published:
Edited by: Sophie Kennedy

In this informative guide, revered consultant laparoscopic, colorectal and general surgeon Mr Anwar Ahmad shares expert guidance on anal fistulas, including the most common symptoms of the condition and insight on the importance of early diagnosis. The leading specialist also outlines the available treatment options and discusses the risks of potential complications of anal fistulas.

What is an anal fistula? Why do anal fistulas occur?

Anal fistula is an abnormal connection between anal canal and skin. There are a number of causes for anal fistulas, the most common being infection in the glands close to the anal canal.


What are the typical symptoms of an anal fistula?

The most common symptom of anal fistula is perianal discharge. Quite often, the first presentation of anal fistula is an anal abscess.


How are anal fistulas diagnosed? Why is early diagnosis important?

The diagnosis of anal fistula is based on clinical and radiological assessment. Clinical assessment can be performed in clinic and under anaesthesia. Radiological assessment is often necessary in recurrent or complex fistulas.

Delayed diagnosis of anal fistula can result in conversion of simple fistulas into complex anal fistulas.


What are the available treatment options for anal fistulas?

There are a number of treatment options for anal fistulas, including placement of setons, laying open of the fistula tract, ligation of the fistula tract, fibrin plug, video assisted treatment and treatment using laser or radiofrequency. Depending upon the severity and complexity of the fistula, the most appropriate form of treatment will vary.


What are the potential complications and long-term consequences of anal fistulas?

The main complication of fistula treatment is incontinence and recurrence. Often the ideal management of a fistula is to maintain a balance between fistula recurrence and faecal incontinence. The newer treatments, such as video assisted treatment and use of laser or radiofrequency, have a higher chance of recurrence but a lower chance of incontinence.



If you are concerned about any symptoms associated with anal fistulas and wish to schedule a consultation with Mr Ahmad, visit his Top Doctors profile today.

By Mr Anwar Ahmad
Colorectal surgery

Mr Anwar Ahmad is a leading consultant laparoscopic colorectal and general surgeon based in Brentwood, Essex and Billericay. He is one of the few paediatric surgeons in Mid & South Essex performing general paediatric surgeries (umbilical hernia, inguinal hernia, orchidopexy). He specialises in minimally invasive proctology techniques. These include non-excisional haemorrhoid treatment (THD, RAFAELO)minimally invasive surgery for anal fistula (VAAFT) and pilonidal sinus (EPSiT). He performs colonoscopies, gastroscopies and surgeries for benign and cancerous colorectal pathologies. He privately practises at Spire Hartswood Hospital and Oakdin Clinic, while his NHS base is Mid & South Essex NHS Trust.

He has an MB BS from the University of Punjab, Pakistan, an MD from Kings College London and a FRCS from the Royal College of Surgeons. 

Mr Ahmad did his basic surgical training in Merseyside. Here, he developed an interest in surgical research which then lead him to complete a higher degree at Kings College London.

He pursued higher surgical training in the North East Thames rotation. He was able to work with world-renowned surgeons at various tertiary centres in London. This provided Mr Ahmad with the highest-quality mentorship and continuing surgical education. Following this, he went on to complete a post CCT fellowship in robotic colorectal surgery in Portsmouth. 

Mr Ahmad, who is the colorectal cancer lead at his NHS trust, is a member of The Royal College of Surgeons (England) and the Association of Coloproctology Great Britain & Ireland (ACPGBI). 

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