WhatsApp
Official logo of Prof. Dr. Zahid Mahmood, laparoscopic and general surgeon in Lahore
Menu
Facebook Icon-instagram-1 Youtube Tiktok

Anal Fistula — Frequently Asked Questions

  • Prof. Dr. Zahid Mahmood
  • August 2, 2026

Anal Fistula — Frequently Asked Questions

Answered by Prof. Dr. Zahid Mahmood — General, Laparoscopic & Laser Surgeon, Lahore.

Will an anal fistula heal without surgery?

No. Because the track stays connected to the inside of the anal canal and is lined with unhealthy tissue, it does not close on its own. Surgery is needed to cure it.

Can antibiotics or creams cure a fistula?

They may settle an associated abscess or infection temporarily, but they cannot close the fistula track. The definitive cure is surgical.

Is a fistula the same as piles?

No. Piles are swollen blood vessels that mainly bleed; a fistula is an infected tunnel that discharges pus. They are different problems with different treatments, although both cause anal symptoms.

Will fistula surgery affect my control over motions?

With proper assessment and the right technique, continence is protected in the great majority of patients. Low, simple fistulas carry very little risk; for higher fistulas, muscle-preserving methods such as seton, LIFT, or laser are used to protect the sphincter.

Is laser treatment for fistula better?

For a suitable, well-defined fistula, laser closure (FiLaC) preserves the muscle, causes less pain, and allows faster recovery. Whether it is right for you depends on the anatomy of your fistula.

How does a fistula form?

It usually begins as an anal abscess from an infected gland. After the abscess drains, a track can remain connecting the inside of the anal canal to the skin — that track is the fistula.

Why do fistulas sometimes come back?

Usually because of a missed internal opening or an undrained branch. Accurate mapping — with examination and, in complex cases, MRI — greatly reduces this risk.

Do I need an MRI?

Not always. Simple, low fistulas are often diagnosed by examination alone. An MRI is very useful for complex, recurrent, or high fistulas to map the track and find hidden branches.

How long is the recovery?

After a simple fistulotomy, the open wound heals over a few weeks, with most people back at work within one to two weeks. After laser or muscle-preserving surgery, recovery is usually quicker.

Is a draining seton uncomfortable?

Once the area settles, a loose seton is usually barely noticeable and allows normal daily activities. It keeps the track draining and prevents painful abscesses while a plan is made.

Can a fistula be caused by TB?

Yes. Tuberculosis is an important cause of anal fistula in our region. A fistula that is unusual, multiple, or persistently recurrent should be tested for TB, as it responds to anti-TB treatment.

Can a fistula be dangerous?

It is not usually dangerous, but it causes repeated abscesses and discomfort, tends to become more complex over time, and very rarely a long-neglected fistula can develop cancer — all reasons to treat it properly and early.

Should I avoid the “guaranteed cure” clinics I see advertised?

Yes, be very cautious. Chemical and thread methods in untrained hands can permanently damage the sphincter muscle and your continence. Fistula surgery belongs only in trained, qualified hands.

When should I seek urgent care?

If you develop a rapidly enlarging, very painful swelling near the anus with fever — this suggests an active abscess needing prompt drainage — or if you feel very unwell with signs of spreading infection.

Is laser fistula treatment available in Lahore?

Yes. Laser (FiLaC) and other modern, muscle-preserving treatments are available, and I offer them along with the full range of options.

How do I book a consultation?

Call Prof. Dr. Zahid Mahmood on 0300 413 0159, or visit professorzahid.com.

This page is for general awareness and does not replace a personal medical consultation.

Related articles

Other conditions we treat