A perianal fistula is a small tunnel that forms under the skin between the anal canal or rectum and the skin around the anus. It often begins after an infection or abscess in one of the anal glands. In people with Crohn's disease, chronic inflammation can lead to repeated fistula formation. Early on, you may not see an opening, but the tract can leak pus or fluid.
Watch for these warning signs:
A perianal fistula most often starts with an infected gland that forms an abscess. If the abscess drains or is treated, a persistent tract may remain. Other factors that can lead to fistula formation include:
Don't let perianal fistula pain control your life. At GastroDoxs in Jersey Village, our board-certified gastroenterologists deliver personalized care from non-surgical seton therapy and biologics for Crohn's-related fistulas to advanced surgical techniques like LIFT and fistulotomy. We make scheduling fast and easy, guiding you step by step toward lasting relief. Call us today at 832-632-4070 or click here to book your appointment online and take the first step toward a pain-free life.
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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.
A perianal fistula is a small tunnel that forms between the rectum or anal canal and the skin near the anus, often developing after an infection or abscess.
Diagnosis typically involves a physical exam and may include imaging studies such as MRI or endoanal ultrasound to map the fistula's course and any associated abscesses.
Yes. Chronic inflammation in Crohn's disease can damage the intestinal wall and lead to repeated abscesses and fistula formation in the perianal area.
Symptoms include persistent pain or tenderness around the anus, swelling, itching, and drainage of pus or blood from the skin near the anus, often worsening after bowel movements.
Recovery time varies by procedure but most patients heal within four to six weeks. Setons and medications may require longer management to fully resolve inflammation.
Antibiotics can help control infection and reduce inflammation but typically do not cure the fistula itself; most patients require a surgical procedure for definitive treatment.
Spontaneous healing is rare. Without medical or surgical intervention, fistulas usually persist or worsen, increasing the risk of complications.
Seek medical evaluation if you experience persistent pain, swelling, or drainage near the anus, or if you suspect you have an abscess or fistula.
Non-surgical approaches include seton placement to maintain drainage, antibiotic therapy, and biologic medications when Crohn's disease is the underlying cause.
Yes. Recurrence is possible, especially in patients with Crohn's disease. Regular follow-up and ongoing management help reduce the risk of new fistula formation.
