1.9K Reviews | 4.7 Star Rating | 20+ years of experience | 72k+ Patients Treated
Perianal Fistula
At GastroDoxs in Houston, Dr. Scott provides expert perianal fistula care, offering personalized diagnosis, advanced treatments such as seton placement and fistulotomy, and supportive lifestyle guidance. With years of experience and patient-centered communication, Dr. Scott ensures effective relief and healing.
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Common Causes and Risk Factors
Blocked anal glands or prior abscess formation
Crohn's disease (chronic inflammation of the digestive tract)
Diabetes or other conditions that weaken immunity
Previous surgery, injury, or radiation in the rectal area
Signs and Symptoms
Pain, tenderness, or swelling around the anus
Red, sore skin near the fistula opening
Pus or blood discharge from a small lump
Fever, chills, or general malaise if infection is present
Itching, irritation, or difficulty with hygiene
How Dr. Scott Diagnoses Perianal Fistula?
Dr. Scott uses a step-by-step approach:
Medical History and Risk Assessment
He reviews your past abscesses, Crohn's disease or other inflammatory bowel issues, prior surgeries, diabetes or immunosuppression, and any related symptoms (pain, swelling, drainage).
Physical Examination
A gentle inspection and palpation around the anal margin to identify the external opening, assess for tenderness, induration, or fluctuance, and check sphincter tone.
Imaging Studies
Endoanal ultrasound to delineate superficial fistula tracts and track their relationship to sphincter muscles.
Pelvic MRI for complex or high fistulas, providing detailed soft-tissue contrast and mapping of secondary extensions.
Fistula Mapping or Contrast Studies (if needed)
In select cases, gentle probing under local anesthesia or fistulography with contrast helps chart the exact course of the tunnel before planning surgery.
Treatment
Our Team offers a full range of care for perianal fistula.
1. Lifestyle and Diet Tips
Drink more water and eat fiber to ease bowel movements
Avoid spicy foods that may irritate the area
Keep the area clean and dry
Wear loose, breathable clothes
2. Medications
Antibiotics to fight infection
Anti-inflammatory medicines for Crohn's-related inflammation
Stool softeners to prevent straining
3. Minimally Invasive or Surgical Options
Seton placement to allow continuous drainage and healing
Fistulotomy to open and clean the fistula tunnel
LIFT or other advanced procedures for deeper or complex fistulas
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Frequently Asked Questions
What causes a perianal fistula?
Most fistulas begin from an abscess in the anal glands. Chronic inflammation like Crohn's disease, diabetes, or prior injury in the rectal area also increase risk.
How is a fistula diagnosed?
Dr. Scott performs a physical exam and may order imaging-MRI or endoanal ultrasound-to map the tract before planning treatment.
What is a seton?
A seton is a soft surgical thread placed through the fistula tract. It keeps the tunnel open to drain and heal while reducing infection risk.
What are my treatment options?
Treatment ranges from lifestyle and dietary changes, antibiotics, and sitz baths to minimally invasive procedures like seton placement, fistulotomy, or LIFT.
How long does recovery take?
Most patients heal within 4-6 weeks. Proper wound care, high-fiber diet, hydration, and avoiding straining help speed recovery.
Is treatment covered by insurance?
Yes. Most major insurance plans cover perianal fistula care. Our team will verify your benefits and guide you through the process.
