Anal Fistulas Specialist

What are anal fistulas?

Anal fistulas are problems affecting the lower gastrointestinal tract where an abnormal connection forms between your rectum and the skin around your anus. Fistulas almost always occur after an anal abscess and may develop even with excellent medical care.

Inside your anus are several small mucus-producing glands. Sometimes, these glands become clogged, resulting in infection and the development of an abscess. Anal abscesses are painful, fluid- and pus-filled swellings like boils. Drainage of the fluid relieves the pressure and pain.

Patients with fistulas have typically already had an anal abscess within the previous 6-18 months. The original abscess heals, but in time, a new abscess develops that might open, drain for a while, then close again.

Several months later, the same thing happens. These recurring abscesses coupled with fluid drainage from the same place in your anus indicate that you have a fistula. Because of the higher pressure in your rectum, gas and stool push through the fistula between bowel movements.

How are anal fistulas treated?

The key to treating anal fistulas is to stop gas and stool pushing through the abnormal connection. Fistulas can't heal without intervention, and in most cases, require surgery.

Shallow fistulas may be comparatively straightforward for Dr. Zehnpfennig to repair by converting the abnormal connection into a channel next to your anus, a procedure known as a fistulotomy. However, deeper fistulas that involve structures such as your anal sphincters can be far more challenging.

What does complex anal fissure surgery involve?

Dr. Zehnpfennig of Montana Colon is fellowship-trained in managing complex anal fistulas. He can perform advanced procedures for treating high fistulas involving the levator ani muscle that general surgeons don't usually do.

Before undergoing complex anal fistula surgery, you may need to have a special drain (seton) in the fistula, which stays there for at least six weeks. One option is to perform an endorectal advancement flap procedure, which involves covering the fistula with a flap of tissue taken from your rectum.

Alternatively, Dr. Zehnpfennig can carry out a LIFT procedure (ligation of the intersphincteric fistula tract). It involves opening the skin above your fistula, spreading the sphincter muscles, and tying off the fistula.

If you're experiencing symptoms of an anal abscess or fistula, you can get an expert diagnosis and advanced surgical repair at Montana Colon. Call the office to schedule a consultation or book an appointment online today.