1.9K Reviews | 4.7 Star Rating | 20+ years of experience | 72k+ Patients Treated
Perianal Fistula
Perianal fistulas are painful tunnels that form beneath the skin near the anus, often following an abscess. Without proper treatment, they can cause pain, swelling, and drainage. Board-certified colorectal specialist Dr. Nghia Nguyen at GastroDoxs in Houston offers expert care.
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
Common Causes and Risk Factors
Infection of an anal gland leading to abscess formation
Incomplete drainage of a perianal abscess
Crohn's disease or other inflammatory bowel conditions
Prior anorectal surgery, injury, or trauma
Smoking or chronic immunosuppression (e.g., steroids)
Diabetes and other conditions that impair wound healing
Signs and Symptoms
Pain or discomfort around the anus, especially when sitting
Redness, swelling, or a tender lump near the anal verge
Drainage of pus, blood, or foul-smelling fluid
Itching, irritation, or itching of the perianal skin
Low-grade fever or general malaise in some cases
Difficulty keeping the area clean or persistent moisture
How Dr. Nghia Nguyen Diagnoses This Condition?
Dr. Nguyen uses a step-by-step approach:
Medical History and Physical Exam
He reviews your symptom history—pain, swelling, drainage—along with prior abscesses, risk factors like Crohn's disease, smoking, or immune status.
Endoscopic Evaluation
An anoscope or small rigid scope is used to inspect the anal canal, locate the internal opening, and assess any inflammation.
Imaging Studies
Endoanal Ultrasound maps the fistula tract relative to sphincter muscles.
Pelvic MRI provides a detailed view of complex or branching fistulas.
Additional Testing (if needed)
When Crohn's disease is suspected, he coordinates blood tests, stool studies, or referral for colonoscopy to confirm underlying IBD.
Treatment
Our Team offers a full range of care for perianal fistula.
1. Diet and Daily Care
Increase fiber intake to keep stools soft
Drink plenty of water
Avoid spicy foods and caffeine during healing
Warm sitz baths to ease pain and promote drainage
2. Medications
Antibiotics to treat infection
Anti-inflammatory drugs for patients with Crohn's disease
Pain relievers to manage discomfort during recovery
3. Minimally Invasive or Advanced Procedures
Seton placement: a soft thread to keep the fistula open and draining
Fistulotomy: opening simple, low fistula tracts to heal from the base
LIFT procedure: ligation of the intersphincteric tract to preserve sphincter muscles
Laser treatment and VAAFT: newer, minimally invasive techniques for less pain and faster recovery
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
Frequently Asked Questions
What causes a perianal fistula?
Most perianal fistulas form when an anal gland becomes blocked and an abscess drains, leaving a tunnel. Other causes include injury, surgery, or Crohn's disease.
How does Dr. Nguyen diagnose a fistula?
Dr. Nguyen performs a physical exam, may use an anoscope, and orders MRI or endoanal ultrasound for complex tracts to map the fistula accurately.
Is surgery always required?
Not always. Simple fistulas may heal with seton placement or non-surgical management, but many require procedures like fistulotomy, LIFT, or minimally invasive laser/VAAFT.
How long is the recovery time?
Patients typically return to light activities within 1-2 weeks; complete healing can take 4-6 weeks depending on the procedure and individual health.
Can diet help with healing?
Yes. A high-fiber diet and adequate hydration keep stools soft and reduce pressure on the fistula site, aiding in comfort and recovery.
What are laser and VAAFT treatments?
These newer, minimally invasive techniques use targeted energy or endoscopic access to seal the tract, resulting in less pain and faster return to normal activities.
Can Crohn's disease cause perianal fistulas?
Yes. Up to one in three people with Crohn's disease develop perianal fistulas. Dr. Nguyen coordinates care with IBD specialists for optimal management.
