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Janette asked...

I was told that I have a small anal fistula.

About 4 years I was told that I have a small anal fistula. This was by a surgeon who was checking my pile situation as some years previously I had had a Haemorrhoidectomy. Needless to say having had the procedure explained to me I was not happy about the thought of having this operation done as I had experienced considerable pain and discomfort for a long time after my Haemorrhoidectomy. I did discuss this with my doctor and whilst I am sometimes troubled with the fistula I decided that I would not do anything about it. Did I make the right decision. I am female and 67 years of age.

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The answer

An anal fistula is a small tube or canal which grows between the lining of the anus (the last bit of bowel before your bottom) and the skin just outside your bottom. Symptoms include pain, skin irritation and sometimes infection, which can lead to a discharge of pus and feeling generally unwell with high fever. They are usually caused by an abscess in the same area, which can grow until it is connected both to the skin and the lining of the anus and then burst. Other possible causes include inflammatory bowel disease, such as Ulcerative Colitis or Crohn’s disease, or sometimes diverticular disease.

Unfortunately, anal fistulae rarely heal on their own. Even if you haven’t had many problems so far, you are at higher risk of an infection, which could make you unwell if you don’t get the fistula operated on. However, it isn’t inevitable that you will get worse problems in the future and anal fistulae certainly aren’t linked to more serious conditions such as cancer. It may be worth your while talking to your GP about getting a consultation with a surgeon to discuss the options for treatment, as there are several options available.

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