Anal Fistula Treatment
In Singapore

If you’re dealing with an anal fistula, consult with a specialist today.

Dr Jonathan Foo Shuo Min
Consultant General Surgeon

What Is An Anal Fistula

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.

Causes of Anal Fistula

Multiple causes may lead to anal fistula including:

  • Infection or an abscess (a collection of pus) due to a blocked anal gland
  • Inflammatory bowel diseases (IBD), such as Crohn’s disease or ulcerative colitis
  • Diverticulitis – a condition where small pouches form in the bowel wall and become inflamed or infected
  • Trauma or injury to the anal region
  • Certain medical conditions, such as HIV or tuberculosis, can weaken the immune system and increase the risk of infection

Symptoms of Anal Fistula

Anal fistula symptoms can vary depending on the location and severity of the problem. Some common signs and symptoms include:

  • Pain and discomfort in the anal area, especially when sitting or during bowel movements
  • Swelling and redness around the anus
  • Persistent drainage or discharge from the area, which may be foul-smelling and may contain blood or pus
  • Irritation and itching around the anus
  • Recurrent anal abscesses or infections

Diagnosis of Anal Fistula

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.

Endoanal ultrasound

A test that uses sound waves to create images of the anal canal, helping to locate and assess the fistula.

Magnetic resonance imaging (MRI)

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.

Types of Anal Fistula

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.

Anal Fistula Treatment Options

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.

Seton placement

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.

Advancement flap procedure

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.

Ligation of the intersphincteric fistula tract (LIFT)

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.

Am I Eligible For Treatment?

Eligibility depends on several factors including:

  • Severity of the condition
  • Overall health status of patient
  • Age
  • Lifestyle of patient
  • Type of fistula

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.

Recovery & Aftercare

While the recovery process and aftercare routine varies depending on treatment and procedure performed, these general recommendations may help:

  • Maintaining good hygiene around the anus to prevent infections.
  • Avoid straining during bowel movements.
  • Follow a high-fibre diet to promote regular bowel movements and reduce strain.
  • Keep up with regular follow-ups for timely assessment and care.

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.

Risks & Complications

While anal fistula treatments are generally safe, as with any medical procedure, they are not without potential risks and complications. These may include:

  • Infection: Despite sterile conditions, there’s a chance of developing an infection post-procedure.
  • Fistula recurrence: There’s a chance that the fistula could return after treatment.
  • Reaction to anaesthesia: As with any procedure requiring anaesthesia, there’s a risk of adverse reactions.

Dr Jonathan Foo Shuo Min

Consultant General Surgeon

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.

  • MBBS (Bachelor of Medicine & Surgery, NUS) 2002
  • MRCSEd (Membership of the Royal College of Surgeons of Edinburgh) 2007
  • MMed (Master of Medicine in Surgery) 2008
  • Further Advanced Training At the Minimally Invasive Colorectal Unit in Portsmouth, UK

Dr Foo firmly believes that every surgical procedures must be customized to the individual in order to achieve an optimal outcome for his patients.

Costs of Anal Fistula Treatment in Singapore

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.

Our clinics are under the following

insurance panels

For Singaporeans, Singapore Permanent Residents and Foreigners.
Please speak to our friendly clinic staff about using your insurance plans.

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    Anal Fistula Treatment In Singapore

    Frequently Asked

    Is anal fistula surgery painful?

    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.

    How long is the recovery process after anal fistula surgery?

    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.

    Can anal fistulas recur after treatment?

    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.

    Can anal fistulas be treated without surgery?

    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.

    What can I do to prevent anal fistulas?

    Maintaining good hygiene, treating any infections promptly, and managing underlying medical conditions can help reduce the risk of developing anal fistulas.