Common symptoms
- A small opening near the anus that discharges pus, blood or fluid
- A boil or abscess that keeps returning in the same place
- Pain, swelling or irritation of the skin around the anus
- Staining of undergarments
See a doctor promptly if
- Fever with a painful, hot swelling near the anus — an abscess needs prompt drainage
- Several openings, or a fistula with diarrhoea and weight loss
- A fistula that has returned after earlier surgery
Treatment without surgery
Antibiotics and dressings can settle infection and pain for a while, but they do not close the tunnel. That is why a fistula tends to return until it is treated.
- Prompt drainage of an abscess, if one is present
- Sitz baths and local hygiene for comfort
- Imaging such as MRI to map complex or recurrent fistulas before treatment
Treatment options
Which option suits you is decided after examination — sometimes the answer is no procedure at all.
Kshar SutraAyurveda
A medicated thread is placed through the tunnel and changed about once a week. It gradually cuts through and heals the tract together, protecting the anal muscle. It has been studied in an ICMR multicentre trial.
Suited toMany simple and complex fistulas — healing takes several weeks
Fistulotomy
The tunnel is opened along its length so it heals from the base up.
Suited toLow, simple fistulas involving little muscle
Fistulectomy
The tunnel is removed completely.
Suited toSelected simple fistulas
Recovery
Most go home the same day or the next morning. With Kshar Sutra you return about once a week for the thread change, and many continue daily work in between. A fistula takes several weeks to heal completely — follow-ups matter.
See the day-by-day timelineInsurance
Salalkar Hospital supports insurance reimbursement — you receive the bills, discharge summary and documents your insurer asks for. Many policies have a waiting period for conditions such as piles, fissure, fistula and hernia, so check your policy wording before planning surgery.
Questions
Why does my fistula keep coming back after antibiotics?
Antibiotics treat the infection, not the tunnel. Once infection settles the opening may close for a while, but the tract remains and fills up again. Closing the tract needs a procedure.
What is Kshar Sutra?
A classical Ayurvedic treatment in which a thread coated with herbal and alkaline preparations is tied through the fistula tract and changed weekly. It cuts through and heals the tract gradually while sparing the sphincter muscle. In an ICMR multicentre trial, healing took longer than with conventional surgery, and fewer recurrences were reported.
Will I lose control of my bowels?
Protecting the muscle that controls continence is a main goal of fistula treatment, and methods such as Kshar Sutra are chosen partly to spare it. Dr. Salalkar explains the risks for your type of fistula before treatment.