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What is an Anal Fistulae and why do I need to treat it?

An anal fistula is a tunnel that forms underneath the skin in the anal region. The fistula connects an infected anal gland inside the anus to the skin around the opening of the anus. It usually occurs when an anal abscess is untreated and the infection worsens and spreads from the anal gland to the surface of the anus. However, a fistula can also occur due to:

  • Rectal cancer
  • STI’s (sexually transmitted infections)
  • Crohn’s disease
  • Anal tuberculosis

This is a serious colorectal condition and requires immediate medical attention. According to the World Health Organization, from 50,000 to 100,000 new cases of anal fistulae are reported each year worldwide. Of these, 30% to 50% of patients start with an anal abscess that worsens into a fistula.

Our board-certified colorectal specialists at Huntington Colorectal Surgeons in Pasadena, California are highly experienced in treating anal fistulae. You can trust your colorectal health with us.

How we diagnose
anal fistulae

Anal fistulae can be very close to the surface of the anal opening and therefore, easy to spot with the naked eye. In some cases, an exam under anesthesia or an MRI is needed to fully delineate the fistula.

Signs & symptoms
of anal fistulae

  • Distressing pain in the anus, especially during a bowel movement.
  • Presence of anal abscess.
  • Foul-smelling discharge from the anus.
  • Redness and swelling at the anal opening.
  • Presence of blood during defecation.
  • Fever and fatigue that manifest along with the above symptoms.

If you notice any of the above symptoms, you must visit our Pasadena colorectal surgical hospital.

Not treating fistulae at the earliest can result in complications like:

  • Fecal incontinence.
  • Extremely severe infection.
  • Formation of multiple severe fistulae.

Our minimally-invasive procedures will ensure a safe and comfortable surgical experience and facilitate quicker healing.

Contact us to schedule a consultation with Dr. Howard Kaufman, Dr. Gabriel Akopian, or Dr. Juliane Golan.

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Surgical treatments for anal fistulae

Our colorectal specialists will first conduct a comprehensive medical evaluation to identify what surgery will successfully treat your fistula. The types of surgery we use to treat anal fistulae are:


This surgery is ideal for cases where the anal fistula doesn’t pass through the anal sphincters. Here, our surgeons will cut completely along the line of the fistula, to open it up and allow it to heal as scar tissue.

Seton techniques

If the fistula passes through the sphincters, the Seton technique is an initial option. Medical-grade sutures are loosely stitched onto the fistula to allow them to drain off the pus. These sutures are later tightened to close the fistula.

Advancement Flap Procedure

Here, the fistulae are resected from the anus and the treatment site is reconstructed using fresh rectal tissue harvested from your rectum. Since this is your tissue, there are fewer chances of tissue rejection post-surgery.

LIFT Procedure

This is a newer technique that is for fistulas with greater involvement of the sphincter muscles. Here, the tissue above the fistula is cut, the sphincter muscles are pushed open slightly, and the fistula’s ends are sutured shut.


This is a newer minimally invasive technique that uses a laser to help shrink the fistula tract. The procedure involves no incisions and is useful in avoiding damage to the sphincter muscles.

Recovering from an Anal Fistulae

Each of these procedures is performed with the assistance of an anesthesiologist in order to ensure your comfort.

Before your procedure, we will provide a detailed care plan that will help optimize your healing, bowel movements, and pain control while you recover from surgery. Feel free to speak to us for more information.


Schedule a Consultation

Contact Us (626) 397-5896