An anal fistula is a small tunnel that develops between the end of the bowel and the skin near the anus (where poo leaves the body).
They're usually the result of an infection near the anus causing a collection of pus (abscess) in the nearby tissue.
When the pus drains away, it can leave a small channel behind.
Anal fistulas can cause unpleasant symptoms, such as discomfort and skin irritation, and will not usually get better on their own.
Surgery is recommended in most cases.
Symptoms of an anal fistula can include:
The end of the fistula might be visible as a hole in the skin near your anus, although this may be difficult for you to see yourself.
See a GP if you have persistent symptoms of an anal fistula. They'll ask about your symptoms and whether you have any bowel conditions.
They may also ask to examine your anus and gently insert a finger inside it (rectal examination) to check for signs of a fistula.
If the GP thinks you might have a fistula, they can refer you to a specialist called a colorectal surgeon for further tests to confirm the diagnosis and determine the most suitable treatment.
These may include:
Most anal fistulas develop after an anal abscess. You can get one if the abscess does not heal properly after the pus has drained away.
Less common causes of anal fistulas include:
Anal fistulas usually require surgery as they rarely heal if left untreated.
The main options include:
All the procedures have different benefits and risks. You can discuss this with the surgeon.
Many people do not need to stay in hospital overnight after surgery, although some may need to stay in hospital for a few days.
Page last reviewed: Sat Jun 2022 Next review due: Sat Jun 2022