Anal fistulas are small channels or connections that form between the rectum and skin near the anus. You may develop an anal fistula if you have an anal gland infection, Crohn's disease, or if you had surgery or radiation therapy near the anus. At NewYork-Presbyterian, our anorectal specialists understand how uncomfortable the pain and swelling of anal fistulas can be. They tailor a plan of care for you to enhance your comfort and quality of life.
An Accurate Diagnosis
Your doctor begins your care with a personal conversation about your medical history, your symptoms, and how they are affecting your quality of life. Fistulas must be carefully assessed to determine their exact location inside the anus. To do this, our physicians use an anoscope—a small instrument to view the anal canal. If your doctor suspects Crohn's disease or ulcerative colitis, you may have a colonoscopy or sigmoidoscopy to examine a larger part of your colon. Based on the results of your assessment and testing, your doctors will decide what treatment is best for you.
Expert Surgical Care
Our colorectal surgeons have extensive experience treating anorectal fistulas, from the simplest to the most complex. Fistula care is complicated and requires knowledge of the special anatomy in this area to drain the infection and cure the fistula while maintaining your bowel control. Your doctor will choose the surgical technique that is most appropriate for your care.
- Fistulotomy. During fistulotomy, the fistula is surgically opened, flushed out, and stitched open or left as is to heal.
- Seton placement. The surgeon places a silk or latex string in the fistula to help drain the infection.
- Advanced rectal flap. For anal fistulas that significantly affect the anal control muscles, the surgeon may create a flap of rectal tissue to cover the internal opening of the fistula.
- LIFT procedure. For complex fistulas, the surgeon accesses the fistula between the sphincter muscles and inserts a seton, widening it over time. A few weeks later, the surgeon removes infected tissue and closes the internal opening of the fistula.