Shiv Shakti Piles Clinic



Dr. SHRIVASTAV B. S. A. M. MUM, Dr.GUPTA B. Sc., B. A. M. S.



There are various type of fistulas in our body but we have to discuss anal related fistula. An anal fistula usually develops after an anal abscess (a collection of pus) bursts, or when an abscess has not been completely treated.


HORSESHOLE FISTULA: Describes a U-shaped connection formed between two external openings on both sides of the anus.

COMPETE FISTULA: Which has two openings, one of which is internal and the other external

INCOMPLEATE FISTULA : Which has an only an external opening.

BLIND FISTULA : Which forms a tube that opens only at one end and is closed at the other. These may turn into complete fistulas if left untreated.

There are two problems that make the treatment of fistula in ano difficult:

A. The anus is an area that can never be completely clean or sterile.

B. Often we cannot completely lay open or excise the fistula because it lies too close or goes through the anal sphincter muscles.

What is Anal Fistula

An anal fistula is a small channel that can develop between the end of the bowel and the skin near the anus.

The end of the fistula can appear as a hole in the skin around the anus. The anus is the opening where waste leaves the body.

Anal fistulas are usually classed as either:

A. simple or complex – depending on whether there is a single fistula tract or interlinking connections

low or high – depending on its position and how close it is to the sphincter muscles (the rings of muscles that open and close the anus)


1. An anal fistula usually develops after an anal abscess (a collection of pus) bursts, or when an abscess has not been completely treated.

2. Fistula can also be caused by conditions that affect the intestines, such as inflammatory bowel disease (IBD) or diverticulitis.

3 .An anal fistula can cause bleeding and discharge when passing stools - and can be painful.

4 .An anal fistula can occur after surgery to drain an anal abscess.

5. Sexually transmitted infections

6. Inflammatory bowel disease

7 .Diverticular disease

8. Rectal cancer


1. skin irritation around the anus

2. a throbbing, constant pain that may be worse when you sit down, move around, have a bowel movement or cough

3. a discharge of pus or blood when having a bowel movement (rectal bleeding)

4. Pain, which is usually constant, throbbing and worse when sitting down

5. Skin irritation around the anus, including swelling, redness and tenderness

6. Discharge of pus or blood

7. Constipation or pain associated with bowel movements

8. Fever

9. Recurrent anal abscesses Pain and swelling around the anus

10. Pain with bowel movements

11. Bleeding

12. Bloody or foul-smelling drainage (pus) from an opening around the anus. The pain may decrease after the fistula drains.

13. Irritation of the skin around the anus due to persistent drainage

14. Fever, chills, and a general feeling of fatigue. (However, these may be symptoms of many conditions.)

Your physician can usually diagnose an anal fistula by examining the area around the anus. He or she will look for an external opening on the skin. If this is visible, your physician will then try to determine the depth and direction of the fistula tract. Often drainage can be produced from the external opening.

Some fistulas may not be visible on the skin's surface. In this case, your physician may need to perform additional tests, starting with endoscopy, in which a special instrument is used to see inside your anus and rectum. Your physician may also order an ultrasound or MRI of the anal area to better define the fistula tract.

If a fistula is found, your physician may also want to do further tests to see if the condition is related to Crohn's disease, an inflammatory disease of the intestine. About 25% of people with Crohn's disease develop fistulas. Among these studies are blood tests, X-rays, and colonoscopy. A colonoscopy, in which a flexible, lighted instrument is inserted into the colon via the anus, is performed under conscious sedation, a type of light aesthetic.


1. Conventional surgical operations for Fistula-in- ano have high recurrence rates, especially in high anal types. Fortunately, there have been excellent results obtained by Ayurveda Kshar Sutra therapy, which can be used extremely effectively to cure Fistulae of almost all the types completely, without any complication or recurrence. It has been well established and proven scientifically by various research centres in India like AIIMS, BHU, ICMR, PGI etc.

2. One should not wait in seeking an expert physician’s/surgeon’s consultation due to shyness or hesitation. As soon as symptoms like persistent or intermittent discharge of pus, soiling of clothes, feeling of some abscess, pain in perianal region etc. appear, expert’s consultation must not be delayed.

3. Since Ayurveda Kshar-sutra therapy is extremely effective in curing fistula-in- ano, one should prefer a qualified and experienced Ayurveda Kshar-sutra specialist doctor over other therapies physicians.

4. Fistula patients feel pain when there is collection of pus inside the track or inside the abscess cavity. So, there must be measures to drain out the collected pus. Though kshar-sutra does the drainage by itself, patient can increase the drainage effectively by keeping themselves ambulatory. So, regular walks will help in healing of your fistula even if you are continuing the Kshar-sutra therapy.

5. Have complete faith in your doctor. After all he has seen and helped many patients like you. Don’t be panic as kshar-sutra therapy sometimes takes longer times (3 months or more) to heal the fistula completely depending on the track length, type of fistula and many more factors.

6. During the kshar-sutra therapy sometimes patient feels pain, burning sensation etc. during and/or after the weekly changing of thread. Have patience. Remember it is only temporary and ultimately you are going to get rid from this disease completely. Follow the instructions of your physician strictly.

7. Sitz bath is a wonderful remedy in relieving the pain. It not only gives a soothing sensation and provides relief from pain but it also helps in keeping the perianal region clean. So, it should be employed correctly as per your doctor’s instructions.


Our anus part should always keep clean and dry sweaty.

Avoids anus intercourse.

If pain around the anus area with shivering and fever you should consult to your doctors.

If any injuries around the anus may be causes of anal fistula.

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