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Perianal Fistula

Perianal fistulas, painful tunnels from the anal canal to the skin, arise after an infected anal gland. If untreated, they cause recurring infections. Dr. Bharat Pothuri at GastroDoxs in Houston offers comprehensive, expert diagnosis and treatment tailored to your needs.

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Texas Medical Board
Harris County Medical Society
American College of Gastroenterology
American Society for Gastrointestinal Endoscopy
Memorial hermann
Houston Methodist leading Medicine
HCA Houston Healthcare
Bharat Pothuri

About the Expert

Dr. Bharat Pothuri is a board-certified gastroenterologist and the founder of GastroDoxs. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

Common Causes and Risk Factors

  • Infection of the small anal glands
  • Crohn's disease or other chronic inflammatory bowel conditions
  • Previous anorectal surgery or traumatic injury
  • Rare infections (e.g., tuberculosis, actinomycosis)
  • Complications of diverticulitis (in uncommon cases)
  • Smoking or diabetes, which can impair normal healing

Signs and Symptoms

  • Persistent pain or discomfort around the anus, worse when sitting
  • Redness, warmth, swelling, or tenderness at the anal opening
  • Pus or blood draining from a small external opening
  • Recurrent perianal abscesses in the same area
  • Fever, chills, or general malaise if infection extends

Expert Treatment for Perianal Fistula by Dr. Bharat Pothuri

Dr. Pothuri uses a step-by-step approach:

Medical History and Exam

He reviews your history of anal infections, prior surgeries or injuries, and checks for conditions like Crohn's disease.

Physical Examination

He inspects the skin around the anus for any external openings, swelling, or signs of draining.

Imaging Studies

  • Pelvic MRI -maps the full course of the fistula tract and identifies any abscesses.
  • Endoanal Ultrasound -provides detailed views of the sphincter muscles and hidden tunnels.

Colonoscopy (If Indicated)

Performed when inflammatory bowel disease is suspected, to evaluate for Crohn's or other colonic conditions.

Bharat Pothuri
Treatment

Our Team offers a full range of care for perianal fistulas.

1. Diet and Lifestyle Modifications

  • Increase dietary fiber from fruits, vegetables, and whole grains
  • Drink six to eight glasses of water daily to promote healing
  • Incorporate gentle walking or light activity to improve circulation

2. Medications

  • Antibiotics to treat or prevent infection in the fistula tract
  • Anti-inflammatory drugs for associated bowel conditions like Crohn's disease
  • Biologic therapies for complex or Crohn's-related fistulas

3. Minimally Invasive or Advanced Procedures

  • Seton placement to allow continuous drainage and gradual healing
  • Fistulotomy to open the tunnel so it can heal from the inside out
  • LIFT Procedure (Ligation of Intersphincteric Fistula Tract) to close the fistula while preserving muscle
  • Laser surgery for precise closure with minimal postoperative pain and quicker recovery
1.5K

Patients Treated

Dr. Pothuri has treated more than 1.5K patients, helping individuals improve their digestive health and overall well-being through expert, personalized care.

20Y

Years of Experience

With over 20 years of experience, GastroDoxs has been a trusted provider of gastroenterology care, focusing on delivering the best outcomes for patients

Bharat Pothuri

About the Author

Dr. Bharat Pothuri is a Board-Certified Gastroenterologist and Hepatologist. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

Frequently Asked Questions

What is a perianal fistula?

A perianal fistula is a small tunnel between the anal canal and the skin near the anus, most often forming after an infected anal gland drains to the surface.

What causes a perianal fistula?

Most fistulas start from an infection in an anal gland. Other risk factors include Crohn's disease, prior anal surgery or injury, tuberculosis, diverticulitis, smoking, and diabetes.

How long is recovery after treatment?

Healing typically takes four to six weeks, though recovery time varies based on fistula complexity and the chosen procedure.

Can a perianal fistula be treated if I have Crohn's disease?

Yes. Dr. Pothuri combines medical therapies (antibiotics, biologics) with minimally invasive procedures to address Crohn's-related fistulas.

When should I see a doctor about symptoms?

If you have persistent pain, swelling, redness, or discharge near the anus-or a history of recurring abscesses-seek medical evaluation promptly.

Is treatment painful?

Most patients experience only mild discomfort, managed with pain medication. Modern techniques like laser surgery and the LIFT procedure minimize pain and speed recovery.

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