What are the symptoms of anal fistula

The problem of anal fistula has a relatively large impact on patients. The most common symptom is pus discharge from the anus. Sometimes it can also cause local itching or problems with defecation. Therefore, we can make a judgment based on these symptoms.

1. The amount of pus discharge is related to the length and size of the fistula. New fistulas discharge more pus, and the secretions irritate the skin and cause itching and discomfort. When the external opening is blocked or falsely healed, pus accumulates in the fistula, causing local swelling and pain, and even fever. The symptoms will disappear only after the sealed fistula ruptures. Due to poor drainage, abscesses may recur and may rupture to form multiple external openings. Larger and higher anal fistulas often have feces or gas discharged from the external opening. During examination, the external opening is often a papillary protrusion or a bulge of granulation tissue. A small amount of pus is discharged when squeezed. Most of the time, there is a single external opening near the anus. There are also multiple external openings, with subcutaneous fistulas connecting the external openings, and the skin becomes hard and atrophied. There are also multiple external openings located on both sides, and the fistula is in the shape of a "horseshoe". Rectal digital examination can touch a nodule or cord-like object in the lesion area, which is tender. By exploring upward along the cord-like object, the internal opening can sometimes be palpated. If the external opening is irregular, not raised, has an undermining edge, has grayish white granulation tissue, or has thin cheesy secretions, tuberculous anal fistula should be suspected.

2. Pain: When the fistula is unobstructed and there is no inflammation, there is usually no pain. Only local swelling and discomfort are felt, which worsens when walking. When the fistula becomes infected or pus is not draining properly and becomes swollen and inflamed, it can cause pain. Internal fistula often causes burning discomfort in the lower rectum and anus, and pain when passing stool.

3. Itching: Due to the continuous stimulation of pus to the skin around the anus, it often feels itchy, damp and uncomfortable around the anus, skin discoloration, epidermal exfoliation, fibrous tissue hyperplasia and thickening, and sometimes eczema.

4. Difficult defecation. If a complex anal fistula does not heal for a long time, it may cause the formation of large fibrotic scars or ring-shaped cords around the anus and rectum, affecting the dilation and closure of the anus, making defecation difficult and causing a feeling of incomplete defecation.