Conditions/Anal Fistula/Chapter
What Causes an Anal Fistula?
Abscess, Crohn’s, and less common triggers
Most anal fistulas start when a perianal gland infection becomes an abscess that drains to the skin, leaving a persistent track. Crohn’s disease, trauma, radiation, tuberculosis, and rarely tumors can also cause fistulas.
Key points
- Anorectal abscess (most common)Tap for details · key note inside
Blocked anal glands → abscess → drainage leaves an open channel. Recurrent swelling at the same site is a strong fistula clue.
- Abscess → drainage → persistent track
- Recurrent swelling
- Antibiotics alone rarely cure the tunnel
- Crohn’s and inflammationTap for details
Perianal fistulas are often complex and recurrent. Medical therapy plus drainage/seton is the foundation—not aggressive lay-open for everyone.
- Other causesTap for details
Prior surgery, radiation, hidradenitis, tuberculosis, or malignancy can mimic or cause fistulas. Atypical features need extra evaluation.
- Risk amplifiersTap for details
Diabetes, immunosuppression, smoking, and chronic diarrhea raise both fistula risk and recurrence after surgery.
More chapters in this hub
Anal Fistula Symptoms
Discharge, recurrent abscess, and urgent warning signs
Anal Fistula Diagnosis
Exam, MRI mapping, and Parks classification
Anal Fistula Treatment Options
Fistulotomy, seton, LIFT, flap, and other options
Anal Fistula Classification
Classification — explained for shared decision-making
Fistulotomy
Lay-open for selected low, simple tracks
Seton for Anal Fistula
Seton: what the procedure aims to do and who it fits
Living with a Seton
Hygiene, activity, and warning signs while draining
LIFT Procedure for Anal Fistula
LIFT: what the procedure aims to do and who it fits
Advancement Flap
Sphincter-sparing closure of the internal opening
Crohn’s and Anal Fistula
Medical therapy plus drainage/seton — shared plan
Anal Fistula Technique Comparison
Comparison — explained for shared decision-making
After Fistula Surgery
Wound care, soft stools, and return to activity
Fistula Recurrence
Why tracks return and how the next plan is built
Abscess and Fistula Link
Infection first, tunnel second
Laser Fistula Treatment (FiLaC)
Sphincter-sparing laser ablation
VAAFT
Video-assisted fistula treatment
Fistula Plug and Fibrin Glue
Filling the tract without cutting
Continence Risk in Fistula Surgery
Protecting control while healing
Appointment / info
This page is for education. It is not medical advice and does not replace a visit with your physician.
Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · Last medically reviewed: August 2026 · English patient-education chapter.