Anal Fistulas
Anal Fistulas – Causes, Symptoms, and Treatment
Anal fistulas are not only uncomfortable but can significantly impact quality of life. Those affected often suffer from anal pain, itching, discharge leading to soiled underwear, and bleeding.
Causes of Anal Fistulas
The causes of anal fistulas are diverse. They often develop due to inflammation of the so-called proctodeal glands — the former scent glands. These glands are located between the internal and external sphincter muscles. When inflammation occurs here, it seeks a path to the outside. In simple cases, this may appear superficially, but in more complex cases, it can penetrate deeper layers of the sphincter muscle and the pelvic floor muscles.
The problem often starts with an anal abscess: a sudden, painful swelling in the anal area that is either surgically drained or later opens through a fistula tract.
Treatment: the surgery for Anal Fistulas
Surgical treatment of anal fistulas requires a delicate touch and surgical expertise. Often, the procedure includes reconstruction of the sphincter muscle. After surgery, physical rest is important for about 14 days. This means avoiding heavy lifting and straining during bowel movements. The external wound should be rinsed with water two to three times daily.
In fistula surgery, there is no 100% success rate. A good outcome is generally defined worldwide as a healing rate of about 80% without fistula recurrence. Thanks to my many years of experience and specialization in treating anal fistulas, I am able to achieve significantly higher healing rates.
Preparation and Additional Examinations
Before surgery, and often also during the healing process after an abscess, a colonoscopy is usually necessary. This allows exclusion of possible causes such as chronic inflammatory bowel diseases or, depending on age, the detection and removal of polyps in the bowel.
With my expertise and individualized care, I ensure that you are in the best hands—from diagnosis to successful treatment.
Anal Abscess
Anal Abscess – Causes, Treatment, and Aftercare
An anal abscess often begins with a sudden, painful swelling in the anal region. In some cases, the abscess may later drain externally through a fistula opening.
Why does an anal abscess require surgery?
Anal abscesses usually require surgical treatment. A spontaneous drainage through a small opening often is not sufficient to completely clear the infection. During surgery, the so-called abscess roof — the surface of the abscess — is opened. Careful examination is performed to check if a fistula tract leads into the anal canal or lower rectum. If such a fistula tract is present, it is treated during the procedure with a special drainage called a seton (ring drainage).
This step is important to lay the foundation for complete healing. After the inflammation subsides, the fistula can be definitively treated in a second procedure. Without this follow-up treatment, there is an increased risk of recurrent abscesses or painful, draining areas in the anal region.
The operation – quick and effective
Treatment of an anal abscess and placement of a seton is usually a short procedure. Generally, patients can go home the same day or the next day at the latest.
Aftercare and additional diagnostics
Once the inflammation has resolved, a colonoscopy is usually recommended. This helps to identify and potentially treat underlying causes such as chronic inflammatory bowel diseases or, depending on age, polyps in the bowel.
Thanks to my experience and precise surgical technique, I ensure that you recover quickly and safely — from initial treatment to long-term healing.
Anal Fissure
Anal Fissure – Causes, Symptoms, and Treatment
An anal fissure is a painful tear in the anal canal, often caused suddenly by hard stools or chemically irritating diarrhea. An anal fissure can be very painful and may also lead to severe bleeding and discharge.
Common causes include:
• Hard stools
• Chronic diarrhea
• Chronic inflammatory bowel diseases
If left untreated, the fissure can extend deeper into the anal canal or sphincter muscle. In the worst cases, a fistula can develop between the internal and external sphincter, often accompanied by a small abscess. In such cases, surgery is usually necessary.
If the anal fissure is detected early, surgery can often be avoided. With timely diagnosis and the correct use of conservative treatments, complete healing is possible within a few weeks. In my practice, I care for many patients who have suffered from anal fissures for a long time and can provide quick relief with simple, individually tailored measures — usually without surgery. Depending on the patient’s age, a colonoscopy is also recommended to rule out other intestinal diseases.
Surgical treatment – targeted and gentle
When surgery is necessary, it is usually an outpatient procedure, and patients can typically go home the same day or the next day. During the operation:
• The entire fissure is carefully removed
• The internal mucosa is sutured
• The external wound is left open to allow complete healing of the inflammation
If a fistula or small abscess has already developed, it will be removed during the procedure. The sphincter muscle is always preserved as much as possible to avoid long-term complications.
With early diagnosis and targeted treatment — whether conservative or surgical — anal fissures can be successfully treated so you can enjoy your daily life free of discomfort.
