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Treatment Options for a Rectal Fistula

If you’ve been diagnosed with a rectal fistula, there are treatment options available that can effectively manage this condition, which can greatly impact your quality of life. Most often, a rectal fistula is the result of an abscess that has developed in one of the anal glands. Once the abscess is drained, it often leaves a narrow tunnel connecting the anal canal to an external opening in the skin near the anus. This opening can be extremely painful, and if not treated promptly, the opening can close up and another abscess can form, repeating the process.

In most cases, a rectal fistula that has been drained will not completely heal on its own. Surgery is the most common form of rectal fistula treatment and provides the greatest chance of preventing a recurrence. Some of the surgical options that are available include:

  • Fistulotomy – This is the most common surgical treatment for a rectal fistula, and involves cutting the length of the fistula open so it can heal flat.
  • Seton techniques – When a fistula affects a significant portion of the anal sphincter muscle, a surgical thread or “seton” can be left in the fistula to allow for draining. The seton is gradually tightened to cut through the fistula while simultaneously allowing the muscle to heal.
  • Glue injections – Fibrin glue is injected into the fistula to seal it and encourage it to heal.
  • Fistula plugs – Bioprosthetic plugs are sometimes inserted into a fistula to close the opening, though this doesn’t guarantee that the fistula will heal completely.
  • Flap procedures – This procedure involves scraping out the fistula and covering the hole in the skin with a flap of tissue.

The gastroenterology team at Tampa General Hospital’s Endoscopy Center can tailor an effective treatment plan for patients with a rectal fistula - addressing the possible causes of rectal fistula and symptoms of rectal fistula - as well as many other anorectal disorders and conditions. We use the most advanced technology available, and have been recognized as one of America’s Best Hospitals in Gastroenterology & GI Surgery in 2019-20 by U.S. News & World Report. Find a gastroenterologist with Tampa General Hospital’s Physician Finder or call 1-800-833-3627.