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Anal Fistula

Small glands are located inside the anus. In some cases, these glands can become blocked and the cavity infected. This is known as an anal abscess, which has a fifty percent chance of becoming an anal fistula. The abscess drains through the skin next to the anus. The fistula then forms a tunnel under the skin and connects with the infected gland.


Most anal fistulas result from an infection that starts in an anal gland. They are common among people with an anorectal abscess, Crohn disease, or tuberculosis. They also occur in people with diverticulitis, cancer, or an anal or rectal injury.


Anal fistulas can cause the following symptoms:

  • Swelling or pain around the anus
  • Uncomfortable/painful bowel movements
  • Bloody drainage or pus around the anus
  • Constipation
  • Fever
  • Fatigue


Diagnosis is based on an examination and other viewing techniques. First, our specialists examine the area around the anus. If the fistula is not visible, they may need to perform an anoscopy, ultrasound, MRI, or sigmoidoscopy. A colonoscopy may be done if we suspect Crohn’s disease.


Treatment of an anal fistula nearly always involves surgery, but some less invasive alternatives exist. These include:

  • Fistulotomy – Most common procedure in which the full length of the fistula is cut to drain the contents.
  • Advancement Flap Procedures – For more complex fistulas, the advancement flap is removed from the rectum, then reattached after the fistula tract is removed.
  • Seton – For patients with high risk of developing incontinence, our surgeons might consider a seton which is a piece of thread that is left in the fistula tract.
  • Fibrin Glue – A nonsurgical option that is not best for long-term results in which fibrin glue is injected into the fistula to seal the tract.

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6060 North Oak Trafficway
Suite 101
Gladstone, MO 64118
Phone: (816) 941-0800

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Overland Park, KS 66211
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Suite 200
Overland Park, KS 66212
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Suite 320
Independence, MO 64057
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Lee’s Summit, MO 64063
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