What symptoms occur with anal fistulas?
The symptoms of an anal fistula are often painful and extremely unpleasant. Typical symptoms of anal fistulas include pain in the anus, burning sensation in the anus, as well as itching in the anus, but also the discharge of pus or secretions through the fistula tract in the anal area, which often causes anal itching. In addition, the tissue around the fistula becomes irritated, can redden, and also swell. The symptoms of anal fistulas can therefore significantly affect your daily life and should not be ignored. Do not hesitate to consult a doctor if you have symptoms. Read more about the diagnosis and examinations of anal fistulas in the blog post Anal Fistula Doctor. We will now go into more detail about the most important, typical symptoms of anal fistulas.
Pain in the anal area
Those affected generally find anal fistulas very unpleasant, as pain often occurs at or in the anus, pain during bowel movements, and generally pain when sitting.
Pus-like, bloody, watery discharge in the anal area
If the fistula tract is open, those affected usually also notice secretions in the anal region. These secretions are watery, bloody, or pus-like and may also contain stool, depending on the location of the anal fistula. This leaking secretion can cause odor nuisance and contamination of underwear, leading to intense itching in the anus. Read more here about anal itching or blood in the stool as a symptom.
Anal itching as a symptom of anal fistulas
Among the most common symptoms of an anal fistula are anal itching and also a burning sensation in the anus, the burning anus. This is because the skin around the fistula opening is irritated by the continuous discharge of secretions from the fistula tract. Often, the tissue in the anal area around the anal fistula is reddened and swollen in those affected. Anal fistulas often resemble a pimple or boil externally. A medical evaluation of the symptoms and thus the possible cause of the anal fistula is recommended promptly. Read more about the examination and diagnosis of anal fistulas in the blog post Anal Fistula Doctor.
Nonspecific disease symptoms in anal fistulas
Other possible symptoms of anal fistulas include bleeding, as well as more general signs of inflammation. These include nonspecific disease symptoms such as general fatigue, tiredness, and fever. Redness, warmth, and swelling of the anal region or involuntary flatulence are also often reported. In severe cases, uncontrolled stool leakage can even occur. If an anal fistula has developed from an anal abscess, those affected sometimes feel a painful swelling in the anal region.
The described symptoms of anal fistulas can also have other causes. In general, complaints in the anal area such as swelling and hardening as well as chronically moist areas, pain, or bleeding during bowel movements should be examined by a proctologically experienced doctor. If you have general malaise, fever, and fatigue, you should immediately seek medical examination and treatment to prevent a potentially life-threatening blood poisoning (sepsis). Read more about examinations and diagnosis of anal fistulas in the blog post Anal Fistula Doctor.
How do you notice an anal fistula? What are the first symptoms of an anal fistula?
Often the first sign of an anal fistula is a strong sensation of pain, followed by symptoms such as often pus-like secretion from the fistula opening and thus also anal itching or intense itching in the anus. In many cases, fever and external signs of inflammation such as redness, warmth, swelling, or even perforation occur. The clinical picture of the anal fistula, if left untreated, can progress to blood poisoning (sepsis). Sometimes the secretion temporarily stops, only to build up pressure again shortly after, which is noticeable through pain and subsides again with renewed secretion from the fistula opening.
Typical symptoms of an anal fistula:
- Pain in or around the anus, especially when sitting or during bowel movements
- Pus-like, bloody, or watery discharge in the anal area
- Swelling and redness in the anal region
- Itching and burning in the anus
- General disease symptoms such as fever, fatigue, and tiredness
Do not hesitate to visit a doctor if you have symptoms of anal fistulas, as an anal fistula usually does not go away on its own and requires treatment, possibly even surgery. It is important to get to the root of the causes of an anal fistula. Read more about diagnosis and examinations in the blog post Anal Fistula Doctor. Here you will also find more detailed information about the treatment of anal fistulas as well as about anal fistula treatment suppositories.
When are anal fistulas rather symptom-poor?
An anal fistula is often only discovered when an anal abscess, an acute pus-filled inflammation, worsens the complaints or symptoms. Some anal abscesses, especially those that have developed over a longer period, are symptom-poor and cause little to no complaints, thus remaining unnoticed and undiscovered for a long time. Also, anal fistulas that occur without a prior anal abscess are rather symptom-poor and often have a connection with chronic inflammatory bowel diseases. Find out more here about the causes of anal fistulas or about the treatment of anal fistulas.
How do I know if I have an anal fistula? Is an anal fistula palpable?
If the anal fistula is close to the skin surface, it can indeed be palpable as a mass, and the affected area is usually swollen and warm, often also with distended, pulsating superficial veins. The exact diagnosis can only be made through medical history and examination by a suitable doctor or specialist. Read more about examinations and diagnosis of anal fistulas in the blog post Anal Fistula Doctor.
What does a fistula on the anus look like?
Often, a fistula on the anus shows a red, swollen spot in the anal region, accompanied by one or more openings from which secretions escape. An anal fistula can be perceived by those affected as a stubborn, painful pimple that manifests in the anal region. This pimple can repeatedly swell and discharge pus. However, not all anal fistulas are obviously palpable. Anal fistulas can also lie much deeper in the tissue. Diagnosis and treatment should therefore be carried out by a doctor who can apply the appropriate diagnostic procedures to make an accurate assessment. Read more about examination and diagnosis of anal fistulas in the blog post Anal Fistula Doctor.
How do the symptoms differ between complete and incomplete anal fistulas?
The complete anal fistula, where a tunnel leads from an internal opening in the anal canal to the skin surface, is distinguished from the incomplete fistula, where the external opening is missing. The symptoms of a complete anal fistula result from the discharge of fluid, pus, or blood through the fistula tract. The moisture leads to skin irritation, irritative anal eczema with anal itching and blood traces on toilet paper. The secretion of pus and fluid can cause an unpleasant odor in the anal area and represents a first symptom. Bleeding or blood in the stool causes great anxiety in the patient. Blood in the stool is always a reason for an endoscopic examination of the colon, a colonoscopy.
A fistula tract that begins at the internal fistula opening and ends without an external opening is called an incomplete anal fistula. Often, an incomplete anal fistula causes few symptoms over long periods and suddenly becomes noticeable due to pain in the anus, palpable hardening, or an acute anal abscess.
Do not hesitate to consult a doctor if you have such symptoms of an anal fistula, as an anal fistula usually does not disappear on its own. Read more in the blog post about Anal Fistula Doctor or how you can prevent anal fistulas.
How do the symptoms differ between anal fistulas and anal abscesses?
Anal fistulas and anal abscesses are considered two different manifestations due to the same cause, inflammation. More often, an anal abscess occurs first, followed by the formation of an anal fistula. Less commonly, the anal fistula appears first, then the anal abscess. An anal abscess can lead to an anal fistula if untreated, when pus finds a way through the surrounding tissue.
The anal abscess is an acute, painful collection of pus, while the anal fistula often represents a chronic consequence of an abscess. An anal abscess usually causes more severe acute pain, whereas an anal fistula can cause moderate pain in the anus, often associated with constant discharge or drainage of secretions or pus through the fistula tract. Fever and general disease symptoms occur more frequently with an anal abscess, while the signs of inflammation in an anal fistula usually remain more localized (secretion, itching, skin irritation).
