Understanding Fistulas and Its Types


“Back in our days, things used to be so simple.”

This is what you’d hear either your parents or grandparents saying and as cliched as it might sound, yet, when you think about it, nothing could spell truth more than this statement.

Apart from rising prices and a compromised environment to add to your health issues, have you thought about the many things you do as a part of your routine that could be potential trouble to your health? For example, commuting to and from work, long hours of sitting in uncomfortable chairs, and no adequate movement or exercise. Amidst all of this, when things get itchy, painful, and troublesome back there, it only calls in for more trouble.

If you are familiar with itchy and painful bottoms, sometimes combined with a foul smell and queasiness, it’s possible that you have either experienced an anal fistula or know someone who has.

Even though this generation is more vulnerable to health issues, especially an anal fistula, yet, with evolving times, people are becoming vocal and workplaces are becoming more and more considerate and understanding towards health conditions that develop due to sedentary lifestyles.

Of the many colorectal conditions people suffer from like piles, fissures and fistula, we will focus on understanding what fistulas are and how they develop. Read on to know more.

Understanding An Anal Fistula

The term fistula is taken from Latin and could also roughly translate as a pipe, flute, or a narrow ulcer. The medical condition ‘fistula’, is an abnormal link between two body cavities such as the rectum and the vagina, or between a body cavity and the skin like the rectum to the skin. This abnormal tunnel between two organs fills up and leaks out fluid that causes pain, discomfort, and foul smell.

Simply put, there are several glands inside the anus and there are chances of these glands getting infected. When that happens, there might be some bacterial fluid building up inside these glands, causing them to swell, leading to an anal abscess. When sometimes these things go away on their own, at many other times, these glands develop a tunnel through which they open up to the exterior of the anus. This channel or tunnel, through which the built-up bacterial fluid oozes out is what is known as an anal fistula.

How Can You Identify An Anal Fistula

Just like any other health condition, an anal fistula also will give you signals of its existence. Some of the most common symptoms of an anal fistula are:


  • Frequent abscesses
  • Pain and swelling
  • Bloody or foul-smelling drainage (pus) from an opening.
  • Irritation on the skin from drainage.
  • Pain with bowel movements.
  • Bleeding
  • Tenderness
  • Fever, chills and a general feeling of fatigue.

Fistula and Its Types

Even though the most common type of fistula is an anal fistula, yet, unfortunately, that’s not the only place in which this menace can exist. Fistulas can occur in any part of the body due to man reasons. Here are some common types of fistulas that you must know about.

  • Obstetric Fistulas: Obstetric fistulas are caused due to obstructed labour. This condition develops in case of prolonged and unattended labour pain. It leads to the development of a tunnel between the woman’s vagina and rectum or bladder.
  • Enterovaginal: Enterovaginal fistula occurs between the vagina and the digestive tract. The primary cause of enterovaginal fistula is inflammatory bowel disease (IBD) and ulcerative colitis. It may lead to gas and foul smelling fluids leaking out of the vagina.
  • Enterovesicular: This type of fistulas have an opening to the bladder. These fistulas may lead to repeated urinary tract infections or the passage of gas from the urethra during urination.
  • Anal Fistula: Anal fistulas are abnormal tube like internal openings in the anal canal and an external opening in the skin near the anus. Anal fistulas generally are a result of drained abscesses that failed to heal completely. There are 4 kinds of anal fistulas pertaining to the sphincter. A ring of muscle guarding or closing the anus or the openings of the stomach is known as sphincter. Here are the 4 kinds of anal fistula:
  • ● Intersphincteric fistula: The narrow tunnel begins in the space between the internal and external sphincter muscles and opens very close to the anal opening.
  • ● Transsphincteric fistula: The fistula begins in between the internal and external sphincter muscles or in the space behind the anus. It then opens an inch or two outside the anal opening.
  • ● Suprasphincteric fistula: This fistula starts in the internal and external ring of muscle known as the sphincter and turns upward to a point above the puborectal muscle, crosses this muscle, then extends downward and opens an inch or two outside the anus.
  • ● Extrasphincteric fistula: This kind of anal fistula begins in the rectum or sigmoid colon and extends downward, then passes through the levator ani muscle and opens around the anus. These fistulas are generally caused due to appendiceal abscess, diverticular abscess or Crohn’s disease.
  • Arteriovenous fistula: Arteriovenous fistulas are abnormal connections or passageways between arteries and veins. These may be defects from birth, surgically created for hemodialysis treatments, or acquired due to pathologic processes, such as trauma or erosion of an arterial aneurysm.
  • Enterocutaneous: This type of fistula begins in the intestine and opens on the skin.

Some kinds of fistula are caused due to abscesses, some are caused as a result of surgeries like hysterectomy. While some fistulas recover over time, for others, medical intervention is important. If you observe symptoms of fistulas, it is important to reach out to a physician so that you can get the right treatment and recover faster.