A fistula-in-the-anus is an abnormal opening at the end of the anal canal, often caused by an abscess. It can lead to pain and requires extensive surgery. It is more common in men and can be caused by injury, radiation, Crohn’s disease, or STDs.
A fistula-in-the-anus is a medical phrase derived from Latin and used to describe an abnormal opening at the end of the anal canal, which is the canal used to remove the byproducts of digestion from the body. The abnormal opening looks like a tube and is called a fistula. It connects to the perianal skin, the region surrounding the junction of the anal canal and the skin of the anal sphincter muscle. Most fistulas in this region are caused by an abscess and are characterized by redness, swelling, tenderness, pain, and often with fever. A fistula in the anus occurs more than twice in men than in women.
This type of fistula usually occurs very close to the sphincter area and results from internal glands in this area that can become blocked, similar to the process that causes skin acne. These glands can then become infected, producing abscesses. The infection can escalate, causing abscesses to progress in the muscle wall and develop channels, or tracts, to the skin.
It has been clinically noted that approximately 70% of all fistulas result from this type of abscess. Also, although abscesses can be treated with a simple surgical procedure called an incision and drainage (I&D), once the abscess has reached the stage of a fistula, more extensive surgery is required. It has also been noted that even if rectal abscesses have undergone I&D, there is still a large chance of developing a recurrent or chronic anal fistula, which would require more intensive surgery.
Other terms used to describe a fistula in the anus are: anal fistula, anorectal fistula, perianal fistula or rectal fistula. All of these terms refer to an abnormal connection between the lining of the anal canal and the skin surface. Because the anal canal is only about 1-1.5 inches (2.5-4.0 cm) long, this immediate area is relatively small. Fistulas tend to be concentrated around the anal sphincter due to the large number of glands in this area that lubricate the sphincter muscles. There are many folds of tissue in this area which could also contribute to the development of anal fissures by drying out and then becoming infected, resulting in the development of abscesses.
Many reasons have been given as possible causes of the development of a fistula in the anus. Although the great majority have been found to be caused by abscesses, some have been known to occur spontaneously. Other more complex and rarer rectal fistulas have been found to be caused by injury, radiation used to treat cancer, complications of Crohn’s disease or sexually transmitted diseases (STDs) – a fistula-in-the-anus can also be caused by a infection following surgery performed for a different reason.
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