What will happen if a fistula is left untreated? - Dr. Rajasekhar M R

Fistula is a disease, this is an infective disorder. What happens is there is something called as anal glands which will be in between the anal sphincters or different areas around the anus. So they will be secreting little secretions into the anal canal to keep it moist, for lubrication purpose there are many glands so when there is constipation or when there is a lot of friction in that areas the glands get infected and then pus will form and when pus forms, we call it and abscess and that causes pain. Then either it opens into the anal canal through the glands duct and it will be secreting inside and the discharge will be coming from inside the anal canal and then we call it as a sinus or if the pus comes outside thorough anal canal through small openings, we call as external openings, we call it as fistulas. Fistulas as tract with one external opening and internal opening and in between that pus will be formed, whenever we detect fistula there is medical line for fistula. Very early stage of abscess even before it has formed abscess, very minimal infection we and give antibiotics and medical line of management but once pus has formed it has come out, it makes its own opening and come out, what we call as a fistula or a surgeon will open it, drain it properly an d clean it to prevent formation of fistula. So once a fistula is formed, there is no medical treatment for curing fistula. Now if we don’t treat a fistula, if we don’t do a surgery for fistula, there are 2 consequences. There are 2 types of fistula. One is a simple fistula where there is a single tract, with a lower openings and only tract is there which is easy to operate and the recurrence rate is very minimal. So that is the stage if it is treated it is cured. Practically it is a curable condition. But if you don’t treat it for long, what happens is this pus will starts spreading to different areas between t he sphincters, crossing the sphincters above the sphincters, outside the sphincters it can spread to different areas, and then we call it as complex fistulas, where the surgery is risky, the damage to the sphincters are possible and recurrence rate goes up very high. So if we don’t treat fistula it is little bit complex fistula. In extremely rare cases, there are repsors that some of the fistulous tracts left for many many years can become malignant or turn into cancers. Sometimes cancer in that area can present as fistula or some other diseases like tuberculosis or Crohn’s diseases, they all present like fistula, but if we treat it like a simple fistula then that disease can spread and cause a havoc. So always the movement we detect a fistula, we have to plan for the treatment and aim for the sure of the disease. So delaying the treatment of fistula doesn’t make any sense.

[DianaGonzalez-whul]

Thank you Doctor for this valuable information.

[lisa-marieevertson]

Wow! Thank you sooo much. I've been to 6 doctors/ surgeons before to sort out my fistula that I've had for a year now (they all extremely pricey, so public hospital for me) and none of them explained this the way you just did. I understood every bit.
Thank you so so so much for this video. It was extremely helpful!
Keep well Doc x

[tankimpoh]

Just done my second surgery just a week ( fistolomy ) and I'm Preet much able to sit and walk feel free to leave a message here cheers everyone and hope you keep your moral high

[jorgetasse]

This guy explained exactly what i needed to learn to get my surgery without telling me 😄

[manazirbinnoohu]

Good Morning Doctor can you please let me know before operation they will give an spinal injuction ???

[indranilsarkar]

Sir.. i m Dr indranil . Passed out from ipgmer kolkata.
Can i contact u personally regarding multitract ?horseshoe fistula ?

[harryharry]

I have currently 2.3cm long tract at posterior perianal region with external opening at 6 o'clok through transsphincteric plane i.e perianal transsphincteric fistulous tract.Beside this, I have been diagnosed anf found 3 hemorrhoids, 1 larger of grade 3 and rest 2 as smaller than that. I did my fistulogram recently for the findings but my confusion goes on about the methods of treatment to take like what method can be the best for every segment : Anal Band, Scleotherapy, Laser therapy .How can I be sure of what to do as every different check ups with different suregeon have different methods like mentioned in the previous statement. Any response or suggestion would be heartedly appreciated as its causing me some psychological problem as well and confusion gets more as I dive into more research. Namaste, currently at Kathmandu, Nepal.

[ajazwani]

My son who's just 10 yrs old was diagnosed with fistula recently. He has no hx of constipation or any other med condition.. Our surgeon advised to wait and watch, as per him surgery at this age is not the best way

[krizzthekid]

Developed one after surgery..it went away.

[srinivasrao]

Tq very much for sharing the Information Dr. My question is what if in the MRI scan there is no internal opening is not found only external opening with little pus.?

Please guide

[mhoxcej]

I have a perianal fitsula since 2009 and i went for 12 operations already now i have seton in and god i cnt wait for this thing to get healed

[fshs]

I wish you could visit in the Philippine so I could consult you, Doc. My fistula has already spread.

[ScorpionPrincess]

I had an operation to drain the abscess and they placed a seton to drain all the proctitis which took several months!
I’ve had an MRI which shows it’s a low intersphisteric fistula and and an endoscopy shows I have no crohns or diverticulitis,

My fistula healed by itself and closed around the seton over a year, eventually the muscle growing back the tunnel became too narrow and the seton snapped, after a month or two the area closed leaving a cable tunnel which I can feel under the skin, no solids would pass but maybe sometimes liquid and not faeces but now only occasionally I will see liquid stain not necessarily drain from the area,

I make sure after each bowel movement I clean the inside of my rectum with wipes so the area doesn’t get infected, and because it’s so hollow on the right side maybe due to an operation I had it’s like all the muscles are rebuilding in that area so I’m very careful to not put pressure when I open my bowels and since it’s hollow I have to make sure I assist that part of my rectum with limited rectal muscles.

So my question is do I need to have another operation?
Or will this heal over eventually?
My problem isn’t that the tract is long it’s like 2cm but the hollowness inside my rectum is even bigger

[unviralwithme]

How much time take to convert simple to complex fistula .
Plz reply

[tamakauahita]

Good evening I was having an abscess it formed into perianal fistula I was operated 3cm it get healing by itself now but now puss is coming out almost a week what can I do now back to hospital again and have another operation?

[remypadil]

Hear me out. Its been two years. My doctor said i can just leave it. It doesn't really bother me. But once every two month it leak puss . Should i go and ask for surgery. Its obviously uncomfortable for me. Plus i use that part of my body for intimate purpose. And during sex it never hurt. (Im a gay bottom)

[parameshshivashimapr]

Sir give information about sinus in ano(blind fistula)

[supernova]

I’m waiting to have surgery for anal abscess and inflamed fistula caused by hidradenitis suppurativa. Will I end up with a colostomy and how long does recovery take? Thank you Doctor

[Kuki-zo]

I have fistula near my anus since 2019 and left untreated, I went to a doctor and he told me to do surgery, but I won't be able to do that because I will be out of station next month, it really doesn't bother me these days and it is not swelling anymore, will it be dangerous for me if I left untreated for another 1 year....??

update: since the past several days there has been alot of bleeding and twice i saw blood clots during cleaning. Its a first seeing blood clots oozing. today during cleaning it seems the fistula opening has reduced in size. I do not know the blood clotting and bleeding means its healing? Still the dressing shows some blood and a brown patch when changing. i pray that these are signs that it is healing. Also anyone in the same situation as me or whats going on.