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In the intersphincteric space it divides again into two tracts (no.). fistula healing is not possible in a significant percentage of patients with complex fistulizing crohns disease managed according to the currently accepted treatment algorithms4-6. In addition, systemic medical treatments may be subject to intolerance or loss of response and surgical treatments such as fistulotomy should be used with caution given the risk of incontinence. Anal fistula is a chronic abnormal communication between the epithelialised surface of the anal canal and usually the perianal skin. An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. Anal fistulae commonly occur in people with a history of anal abscesses. Surgery for an anal fistula is usually carried out under general anaesthetic. In many cases, its not necessary to stay in hospital overnight afterwards. The aim of surgery is to heal the fistula while avoiding damage to the sphincter muscles, the ring of muscles that open and close the anus, which could potentially result in loss of bowel control (bowel incontinence). Perianal fistula (or fistula-in-ano) (plural fistulae or fistulas) is the presence of a fistulous tract acrossbetweenadjacent to the anal sphincters and is usually an inflammatory condition 4. summary points anal fistula is part of the spectrum of perianal sepsis. It is a chronic condition that may present de novo or after an acute anorectal abscess. Anal fistula causes a variety of prolonged or intermittent symptoms including pain, discharge, and social embarrassment. The goals of management are to eradicate the fistula and prevent recurrence while maintaining continence. An anal fistula is a small tunnel that develops between the end of the bowel and the skin near the anus (where poo leaves the body). Theyre usually the result of an infection near the anus causing a collection of pus in the nearby tissue. When the pus drains away, it can leave a small channel behind. Anal fistula what is an anal fistula? An anal fistula is a small tunnel that connects an abscess, an infected cavity in the anus, to an opening on the skin around the anus. The anus is the external opening through which feces are expelled from the body. If youre dealing with one or more fistulas, youll surely want them to be gone. Ive put together a basic guide to anal fistulas to help you understand this difficult condition and what options are available.