If you’re dealing with an anal fistula, consult with a specialist today.
A small tunnel that develops between the end of the bowel, known as the anal canal, and the skin near the anus. This abnormal connection causes irritation, inflammation, and discomfort. Treatment aims to close the fistula, relieve your symptoms, and prevent any complications that may arise. In most cases, surgery is the primary treatment method for anal fistulas.
Multiple causes may lead to anal fistula including:
Anal fistula symptoms can vary depending on the location and severity of the problem. Some common signs and symptoms include:
A physical examination will be conducted and may involve a digital rectal exam (DRE) to assess the anal canal’s condition and detect any abnormalities. Further diagnostic tests may be necessary to confirm the diagnosis and determine the fistula’s characteristics. These can include:
A procedure in which a small instrument, called an anoscope, is inserted into the anus to visualise the anal canal and identify any fistulas.
A test that uses sound waves to create images of the anal canal, helping to locate and assess the fistula.
An imaging technique that provides detailed pictures of the anal region, allowing for a more accurate assessment of the fistula and surrounding tissues.
A type of X-ray that involves injecting a contrast dye into the fistula to help visualise its path and extent.
Anal fistulas are classified into various types based on their location, complexity, and relationship to the anal sphincter muscles. The main types of anal fistulas include:
These are the most common type of anal fistula, accounting for about 70% of cases. They occur between the internal and external anal sphincter muscles.
These fistulas pass through the external sphincter muscle and account for approximately 25% of cases. They are more challenging to treat due to the risk of damaging the sphincter muscles.
These rare fistulas travel above the external sphincter muscle and account for about 5% of cases.
Extremely rare, these fistulas originate outside the anal sphincter muscles and may extend to other organs.
Surgery is the primary treatment for anal fistulas, with various techniques available depending on the fistula’s complexity and location. The main surgical options include:
Cutting open the fistula tract and converting it into an open wound, before leaving it to heal. This can take between a few weeks to several months.
In this procedure, a small, flexible tube is threaded through the fistula tract and tied in a loop. This helps to gradually heal the fistula without causing damage to the sphincter muscles.
This technique is often used for complex fistulas and involves covering the internal opening of the fistula with a flap of tissue. This helps to promote healing and prevent recurrence.
This minimally invasive procedure involves removing the fistula tract and closing the internal and external openings with sutures.
In some cases, non-surgical treatments may be recommended, such as medication for managing symptoms, antibiotics for treating infections, or pain relief measures. These treatments are typically used in conjunction with surgery or as a temporary solution while awaiting surgery.
Eligibility depends on several factors including:
Patients with complex fistulas, multiple fistulas, or underlying conditions such as Crohn’s disease may require specialised care. General health status, age, and lifestyle may also influence the chosen treatment method.
While the recovery process and aftercare routine varies depending on treatment and procedure performed, these general recommendations may help:
Complete recovery time can vary, ranging from a few weeks to a few months, depending on the complexity of the fistula and the treatment procedure.
While anal fistula treatments are generally safe, as with any medical procedure, they are not without potential risks and complications. These may include:
Dr Jonathan Foo has expertise in managing various General Surgical and Colorectal conditions. He excels at advanced endoscopic, open and minimally invasive (“key-hole”) techniques, as well as robotic surgery.
Dr Foo is a specialist Colorectal surgeon with comprehensive training in other minimally invasive(laparoscopic) General Surgical conditions such as hernia repair and gallbladder surgery.
Dr Foo firmly believes that every surgical procedures must be customized to the individual in order to achieve an optimal outcome for his patients.
The cost of anal fistula treatment in Singapore can vary depending on several factors, including the complexity of the condition, the chosen surgical procedure, and the healthcare provider.
For Singaporeans, Singapore Permanent Residents and Foreigners.
Please speak to our friendly clinic staff about using your insurance plans.
We are committed to providing a one-stop experience, where you’ll receive a meticulous consultation and high-quality service in a comfortable environment.
While any surgical procedure can cause some discomfort, the specialist will take steps to minimise pain during and after the surgery. Pain management methods, such as medication and ice packs, can help alleviate postoperative pain.
The recovery time following anal fistula surgery can vary depending on the type of procedure and your overall health. It may take anywhere from a few weeks to several months to fully heal from the surgery.
There is a risk of recurrence with any anal fistula treatment. However, choosing the most appropriate surgical technique, adhering to proper wound care, and addressing any underlying causes can help minimise this risk.
In some cases, non-surgical treatments may be used to manage anal fistula symptoms temporarily. Surgery is typically the most effective and definitive treatment for anal fistulas.
Maintaining good hygiene, treating any infections promptly, and managing underlying medical conditions can help reduce the risk of developing anal fistulas.
