Last Updated on November 26, 2025 by Bilal Hasdemir
Do you have anal pain, leakage, or see a small hole near your anus? These signs might mean you have a rectal fistula. A rectal fistula pictures is when there’s an abnormal connection between the anus and the skin around it.
Liv Hospital uses the latest methods to help find possible rectal fistulas. They focus on the patient, giving care and compassion. Knowing the signs and symptoms is key to getting the right help.
Understanding the symptoms and what a rectal fistula looks like is important. It helps you find the right treatment. Keep reading to learn more about the signs and symptoms of rectal fistulas.
Key Takeaways
- Rectal fistulas are abnormal connections between the anal canal and the skin near the anus.
- Symptoms include anal pain, leakage, and a small hole near the anus.
- Liv Hospital offers a patient-centered approach for diagnosing and treating rectal fistulas.
- Understanding the signs and symptoms is key for the right medical care.
- Early diagnosis and treatment can greatly improve outcomes.
Understanding Rectal Fistulas: Definition and Causes
To tackle rectal fistulas, we must first understand what they are and how they form. A rectal fistula is an abnormal tunnel between the rectum and the skin around the anus. This condition can cause discomfort and complications if not treated.
What Is a Rectal Fistula?
A rectal fistula is a small tunnel between the bowel and the skin near the anus. It often comes from an infection or abscess that doesn’t heal. This can lead to ongoing pain, discomfort, and discharge.
Medical experts say an anal fistula is a chronic issue needing proper diagnosis and treatment. Knowing about rectal fistulas helps us understand their causes and risk factors.
Common Causes of Fistula Development
Rectal fistulas often start with an anal abscess, a pocket of pus near the anus. If this abscess doesn’t heal, it can turn into a fistula. Other causes include infections, inflammatory bowel disease, trauma, and surgery.
- Infections
- Inflammatory bowel disease (IBD)
- Trauma to the anal region
- Surgery
These conditions can raise the risk of fistula by causing infections or abscesses.
Risk Factors for Developing Anal Fistulas
Some factors increase the chance of getting an anal fistula. These include:
| Risk Factor | Description |
| Crohn’s Disease | A type of inflammatory bowel disease that can increase the risk of fistula development. |
| Previous Anal Surgery | Surgical procedures in the anal region can sometimes lead to fistula formation. |
| Anal Abscesses | Recurrent or unresolved abscesses can lead to the development of a fistula. |
Knowing these risk factors helps in early detection and prevention of complications from rectal fistulas.
A medical expert notes, “Early diagnosis and treatment of conditions like anal abscesses can significantly reduce the risk of developing a rectal fistula.” This shows the importance of seeking medical help if symptoms don’t improve or get worse.
Rectal Fistula Pictures: Visual Identification Guide
Knowing how to spot a rectal fistula early is key. These fistulas, also known as anal fistulas, have clear signs. These signs help doctors diagnose them quickly.
External Appearance of Anal Fistulas
Anal fistulas look different, but they often have a visible hole near the anus. This hole is a key sign that sets fistulas apart from other anal issues.
Identifying a Small Hole Near the Anus
A small hole near the anus might mean you have a perianal fistula. This hole is usually where the fistula tract meets the outside. It might also connect to an inside opening in the anal canal.
Why You Might Notice Two Holes in the Anal Area
Sometimes, people see two holes in the anal area. This happens when there are multiple fistula tracts. Or when a fistula has both an inside and outside opening that can be seen.
| Visual Characteristic | Description |
| External Opening | A visible hole near the anus, marking the external orifice of the fistula. |
| Fistula Tract | The path that connects the internal and external openings of the fistula. |
| Discharge or Drainage | Presence of pus or other fluid emanating from the fistula opening. |
Spotting these signs is important for getting the right medical help. If you think you might have a rectal fistula, see a doctor. They can give you the right diagnosis and treatment plan.
Primary Symptoms of Rectal Fistulas
Knowing the main symptoms of rectal fistulas is key for early treatment. These symptoms can really affect a person’s life quality.
Pain and Discomfort Patterns
Pain is a big symptom of rectal fistulas. It can be constant and get worse when you move your bowels or sit. Anal fistula pain can feel sharp or throbbing.
The way the pain feels can tell you where the fistula is and how complex it is. For example, pain when you poop might mean the fistula is near the anus.
Discharge and Drainage Issues
Discharge or drainage is another key symptom. This can be pus or feces coming out near the anus. Anal fistula discharge can be uncomfortable, cause skin problems, and make it hard to stay clean.
The type of discharge can help doctors figure out what’s going on. For instance, if it’s fecal, it might mean the fistula is linked to the rectum.
Swelling and Inflammation Signs
Swelling and inflammation around the anus are also signs of rectal fistulas. You might see redness and feel warmth. Perianal fistula pain can get worse with inflammation.
| Symptom | Description | Clinical Significance |
| Pain | Sharp or throbbing pain, often worse during bowel movements | Indicates fistula presence and possible connection to anal canal |
| Discharge | Pus or fecal matter leaking from the fistula opening | May indicate connection to rectum or infection |
| Swelling/Inflammation | Redness, swelling, and warmth around the anus | Signifies possible infection or abscess formation |
Spotting these symptoms early is important for getting the right treatment. A doctor can give a proper diagnosis and suggest the best treatment.
How to Tell If You Have a Fistula: Self-Assessment Guide
Knowing the signs of a rectal fistula is key to getting the right medical care. A self-assessment guide can help you spot warning signs. It also tells you when to see a doctor.
Key Warning Signs to Watch For
There are several signs that might mean you have a rectal fistula. These include:
- Persistent pain near the anus that doesn’t subside
- Unusual discharge or drainage from the anal area
- Swelling or inflammation around the anus
- Recurring abscesses or boils near the anal region
Knowing these symptoms can help you figure out if you might have a fistula.
When to Suspect a Fistula vs. Other Conditions
It’s important to tell the difference between fistula symptoms and other anal or rectal issues. For example, hemorrhoids can cause discomfort and bleeding but are different from fistulas. If you have persistent or severe symptoms, seeing a healthcare professional for a correct diagnosis is vital.
Tracking Your Symptoms Effectively
Keeping a record of your symptoms can be very helpful. You might want to make a table to track:
| Symptom | Date | Severity | Additional Notes |
| Pain | 02/01 | 8/10 | Worsens during bowel movements |
| Discharge | 02/02 | Yes | Noticed after sitting for long periods |
| Swelling | 02/03 | Moderate | Visible near the anus |
Tracking your symptoms can give you insights. It also helps your healthcare provider make a more accurate diagnosis.
Types of Anal Fistulas and Their Specific Symptoms
Anal fistulas come in different forms, each with its own symptoms and traits. Knowing these variations is key for correct diagnosis and treatment.
Intersphincteric Fistulas
Intersphincteric fistulas are common. They happen between the internal and external anal sphincters. Symptoms include ongoing discharge and pain, worse during bowel movements.
Transsphincteric Fistulas
Transsphincteric fistulas go through the external anal sphincter. They connect the anal canal to the skin. These fistulas cause a lot of discomfort, like pain and swelling in the perianal area.
Suprasphincteric and Extrasphincteric Fistulas
Suprasphincteric fistulas are complex, affecting the area above the puborectalis muscle. Extrasphincteric fistulas are even more complex, often due to trauma or surgery. Both types have tough symptoms, like recurring abscesses and ongoing drainage.
Rectoanal Fistula Characteristics
A rectoanal fistula is a complex type that links the rectum to the anal canal or skin. Symptoms include fecal incontinence, recurring infections, and a lot of pain. It’s important to use imaging like MRI for accurate diagnosis and treatment.
| Type of Fistula | Common Symptoms | Characteristics |
| Intersphincteric | Pain, discharge | Occurs between internal and external sphincters |
| Transsphincteric | Pain, swelling | Traverses the external anal sphincter |
| Suprasphincteric | Recurrent abscesses, drainage | Involves area above puborectalis muscle |
| Extrasphincteric | Recurrent infections, pain | Often results from trauma or surgical complications |
| Rectoanal | Fecal incontinence, infections, pain | Connects rectum to anal canal or skin |
Knowing the specific type of anal fistula is key for the right treatment. Each type has its own challenges. A detailed diagnosis is vital for effective management.
Fistula Cysts and Abscesses: Related Complications
It’s important to know how fistula cysts, abscesses, and rectal fistulas are connected. Rectal fistulas can cause abscesses and fistula cysts to form. This is why managing them well is key.
How Abscesses Lead to Fistula Formation
Abscesses are pus-filled pockets near the anus, often from infection. They can create a path for bacteria, leading to fistulas. The link between abscesses and fistulas is strong, as repeated abscesses raise fistula risk.
An infection causes an abscess. If not treated, it might drain on its own or through surgery. But, if the infection isn’t fully cleared, a fistulous tract can form.
Recognizing a Fistula Cyst
A fistula cyst is a fluid-filled sac linked to a fistula. Look for a lump or swelling near the anus with pain, redness, or discharge. Seeking medical help is vital if these signs appear, as they might mean a fistula complication.
Managing Recurrent Abscesses
It’s important to manage recurring abscesses to avoid fistulas. Treatments include antibiotics, abscess drainage, or other methods to fight infection. Quick medical care is essential to handle abscesses well and lower complication risks.
Complications of Untreated Fistulas
Ignoring fistulas can cause many problems, like more abscesses, ongoing pain, and serious infections. Getting medical help quickly is vital for better results.
Ignoring fistulas can also spread infection, leading to severe conditions. So, it’s critical to tackle fistulas and related issues fast.
Pain Levels and Characteristics of Anal Fistulas
Anal fistulas can cause pain that ranges from mild to severe. This pain is a big worry for those affected. It can make everyday tasks hard.
Are Fistulas Always Painful?
Not every anal fistula hurts, but many people feel some discomfort. The pain’s level can change based on the fistula’s location and how complex it is.
Pain characteristics: Pain can be steady or come and go. It can feel sharp or just a dull ache.
Pain During Bowel Movements
Pain when you have a bowel movement is common with anal fistulas. This pain gets worse when stool goes through the anal canal, if the fistula is near the opening.
Factors influencing pain during bowel movements: Stool consistency, inflammation, and fistula size all affect how much pain you feel during defecation.
Perianal Fistula Pain Patterns
Perianal fistula pain can show up in different ways. Some people feel pain in their buttocks or thighs. Others feel pain only around the anus.
| Pain Pattern | Description |
| Localized Pain | Pain confined to the area around the anus |
| Radiating Pain | Pain that spreads to the buttocks or thighs |
| Intermittent Pain | Pain that comes and goes, often related to bowel movements or activity |
When Fistula Pain Indicates an Emergency
In some cases, fistula pain means a serious problem that needs quick medical help. Severe pain, fever, swelling, or trouble controlling bowel movements could mean an abscess or infection.
Emergency symptoms: Sudden pain increase, fever, swelling, or trouble with urine or stool passing are urgent signs to seek medical help.
Diagnostic Process for Rectal Fistulas
Diagnosing a rectal fistula is a detailed process. It includes physical exams, imaging tests, and sometimes lab tests. This approach is key to finding the right treatment.
Physical Examination Procedures
A physical exam is the first step. A healthcare provider looks for signs of a fistula, like an opening or drainage. They might also do a digital rectal exam (DRE) to feel for abnormalities.
This exam is important. It helps the provider see the fistula’s external opening and check the tissue around it for signs of infection.
Imaging Tests for Fistula Confirmation
Imaging tests help confirm the diagnosis and understand the fistula’s extent. These tests include:
- Magnetic Resonance Imaging (MRI): MRI shows the fistula tract and its relation to nearby structures.
- Computed Tomography (CT) Scan: A CT scan identifies the fistula and any related abscesses or complications.
- Endoanal Ultrasound: This uses a probe in the rectum to image the anal sphincter and fistula tracts.
Laboratory Tests and Their Significance
Laboratory tests check for infection or inflammation. They include:
| Test | Purpose |
| Complete Blood Count (CBC) | To check for signs of infection or inflammation, such as an elevated white blood cell count. |
| C-Reactive Protein (CRP) | To assess the level of inflammation. |
| Blood Cultures | To identify any bacteria that may be causing an infection. |
Differential Diagnosis Considerations
When diagnosing a rectal fistula, other conditions must be ruled out. These include anal fissures, abscesses, or inflammatory bowel disease. A detailed diagnostic process ensures an accurate diagnosis.
“Accurate diagnosis is the cornerstone of effective treatment for rectal fistulas. A thorough diagnostic approach ensures that patients receive appropriate care tailored to their specific condition.”
— Medical Expert
Treatment Options for Rectal Fistulas
Understanding how to treat rectal fistulas is key. There are surgical and non-surgical methods. The right choice depends on the fistula’s complexity, the patient’s health, and any other conditions.
Surgical Approaches
Surgery is often needed for rectal fistulas, mainly for complex or long-lasting cases. The main goal is to close the fistula without harming the anal sphincter.
- Fistulotomy: This method opens the fistula to heal from the inside out.
- Seton Placement: A thread or rubber band is used to drain and heal the fistula.
- Fibrin Glue Injection: This method uses fibrin glue to seal the fistula tract.
Non-Surgical Management Techniques
Not every rectal fistula needs surgery. For simple or early cases, non-surgical methods can work well.
Conservative management includes:
- Antibiotics to fight infection
- Medication for pain
- Changes in diet to ease symptoms
Recovery and Post-Treatment Care
Recovery time varies based on the treatment. Proper care after treatment is vital to avoid complications and aid in healing.
| Treatment Type | Recovery Time | Post-Treatment Care |
| Surgical | Several weeks | Wound care, pain management |
| Non-Surgical | Varies | Monitoring for infection, dietary adjustments |
Managing Recurrent Fistulas
Dealing with recurrent fistulas is tough. They often need aggressive treatment, like repeated surgery or other therapies.
Knowing the treatment options for rectal fistulas is important. It helps in making the right care choices. Healthcare providers can plan the best treatment by considering the fistula’s complexity and the patient’s health.
Conclusion: When to Seek Medical Help for Suspected Fistulas
If you’re feeling persistent or worsening symptoms that might mean a rectal fistula, get medical help fast. Knowing the signs and when to act can greatly improve your treatment and health.
Don’t ignore symptoms like constant pain, discharge, or swelling near the anus. If you see these signs, see a doctor right away. They can give you the right diagnosis and treatment plan. Waiting too long can cause more problems, like abscesses and more pain.
When you go to the doctor for suspected fistulas, tell them all about your symptoms. Share when they started and what makes them better or worse. A doctor will check you thoroughly, maybe with tests, to see if you have a fistula.
Getting help early can stop more problems and make treatments work better. By knowing when to seek medical help, you can start fixing the issue and get your health back.
FAQ
What is a rectal fistula?
A rectal fistula is an abnormal tunnel between the anus or rectum and the skin around it. It can cause pain, discharge, and swelling.
How do you know if you have a fistula?
Look out for persistent pain, swelling, or discharge around the anus. A small hole or opening near the anus is also a sign. Recurring abscesses or infections in the anal area are other indicators.
Are fistulas painful?
Yes, fistulas can be painful. The pain can be mild or severe and may happen all the time or during bowel movements.
What does an anal fistula look like?
An anal fistula looks like a small hole near the anus. It may also show signs of swelling, redness, or discharge.
Why do I have two holes in my bum?
Two holes in the anal area might mean you have a fistula. One hole connects to the rectum or anus, and the other is on the skin.
What are the primary symptoms of rectal fistulas?
Main symptoms include pain, discharge, swelling, and inflammation around the anus. Symptoms can vary based on the fistula’s type and location.
How is a rectal fistula diagnosed?
Diagnosis starts with a physical exam, possibly a digital rectal exam. Imaging tests like MRI or ultrasound and lab tests for infection or inflammation may also be used.
What are the treatment options for rectal fistulas?
Treatments include surgery to close the fistula and non-surgical methods to manage symptoms. Post-treatment care is also important to prevent complications and recurrence.
Can a fistula heal on its own?
No, a fistula usually needs medical treatment to close the abnormal connection. This is to prevent ongoing symptoms and complications.
How can I manage perianal fistula pain?
To manage pain, try pain relief meds, sitz baths, and comfort measures. But, treating the fistula itself is key to prevent ongoing pain and complications.
What is a fistula cyst?
A fistula cyst is a complication of a fistula. It’s an abscess or cyst along the fistula tract, causing more pain, swelling, and discharge.
How do abscesses lead to fistula formation?
An abscess in the anal area can turn into a fistula if it doesn’t drain fully or if the infection stays. This can create a tunnel or connection between the anus or rectum and the skin.
References
- Jairath, A., & Kaur, M. (2021). Management of Anal Fistula: A Review of Advances and Surgical Techniques. International Journal of Surgery, 87, 105932. https://www.sciencedirect.com/science/article/abs/pii/S1743919121002933
- Garg, P. (2018). Anal Fistula: What Do We Know? World Journal of Gastroenterology, 24(46), 5201-5212. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289547/
