Anal Fistula Symptoms: How to Tell It Apart From Piles or an Abscess

You notice a small, tender bump near your anus. A few days later, it bursts and drains something unpleasant. The pain and discomfort might be gone, and you might think that it is over. However, weeks later, it again appears in the same spot.

In such situations, you are not suffering from piles, a boil or an abscess. The symptom is an example of an anal fistula, a condition that is often mistaken for haemorrhoids and goes away without proper treatment.

The main problem that leads to complications of anal fistula is a delay in seeking timely medical advice. This is because the condition is highly misunderstood. It usually begins as a simple infection, due to which patients spend months applying ointments or sitting in warm water.

By the time patients consult the doctor, the condition has already progressed, which worsens the pain and discomfort. In this blog, Dr. Purnendu Bhowmik, the best fistula surgeon in Kolkata, gives a clear guide to help you understand the difference between an anal fistula and piles or an abscess.

What is an Anal Fistula?

An anal fistula is an abnormal little tunnel-like passage which forms between the inside of the anal canal and the skin around the anus. This occurs when an infected anal gland develops an abscess. Even when the abscess is drained or treated, the opening may remain, causing recurrent infections and discharge. Now, that tunnel is the fistula.
It keeps leaking pus, blood, or fluid to the skin. An anal fistula does not heal by itself because bowel contents and bacteria keep entering the tract from inside the anal canal.

What Are the Signs That You Have an Anal Fistula?

The symptoms of an anal fistula are not the same for all individuals. They generally vary depending on the severity of the condition and the depth of the tract. As the best fistula surgeon in Kolkata, Dr. Purnendu Bhowmik lists the common symptoms patients complain of.

• Persistent or recurring purulent discharge of pus, blood, or foul-smelling fluid from a small opening near the anus
• Pain or throbbing around the anus, often worse when sitting, moving, coughing, or passing stool
• Swelling, redness, and a visible lump near the opening that feels warm to the touch.
• Skin irritation and itching caused by constant moisture and discharge. Scratching might provide temporary relief but often causes minor tears.
• A small boil-like opening on the skin that may seem to heal and then reopen
• Fever, chills, or a general feeling of being unwell if the infection becomes more serious.
• Occasional leakage of stool or gas in more complex cases

One of the defining characteristics of an anal fistula is the cycle of discomfort- there is pain followed by discharge, then relief follows, but again the problem returns. This on-and-off discomfort strongly suggests you have a fistula, not just piles.

How are Piles Different From an Anal Fistula?

Piles are a swollen collection of veins and tissues inside or around the anus and lower rectum, typically caused by constipation, straining and prolonged sitting. The typical symptoms of piles include

• Bright red blood on toilet paper or in the bowl after passing stool
• A soft lump or swelling that may protrude during bowel movements
• Persistant itching, burning or mild discomfort around the anus due to mucus.
• A feeling of incomplete evacuation even after passing stool.
• Pain mainly during or just after passing stool, especially with external or thrombosed piles.
• In some cases, a slimy, whitish discharge from the anus piles that increases the irritation.
• A dull ache or pressure when sitting for long periods.

Piles do not create a tunnel or a continuous pus discharge. The main symptoms are bleeding and lumps, but not a persistent draining opening on the skin.

Whenever you consult one of the best fistula surgeons in Kolkata, like Dr. Purnendu Bhowmik, he will carefully assess your symptoms and recommend the appropriate diagnostic tests and treatment based on your condition.

What is an Anal Abscess?

An anal abscess is another painful condition in which there is pus discharge near the anus and rectum caused by infection. It is often the first stage that leads to a fistula. Some of the warning signs are as follows.

• Sudden, severe, throbbing pain that worsens when sitting or walking
• A red, swollen, hard, tender lump near the anus
• High fever and chills
• Difficulty sitting or passing stool
• Relief of pain once the abscess bursts or is drained
• A feeling of pressure or fullness around the anus
• Difficulty urinating if the abscess is large and close to the surrounding area.

According to Dr. Purnendu Bhowmik, the best fistula surgeon in Kolkata, an abscess is generally more acute, developing over days and is extremely painful.

The main reason for the confusion between the diagnosis of the three conditions is that they develop around the same area and cause overlapping symptoms.

An abscess and a fistula are directly related and stages of the same infection. However, piles are a separate condition and have different causes.

The three conditions can look and feel alike and can even occur together, which is why it is easy to mistake one for another. Hence, a thorough examination by an experienced surgeon can confirm the actual condition.

Dr. Purnendu Bhowmik, one of the best fistula surgeons in Kolkata who is also well-known for the treatment of other anorectal conditions, conducts a thorough examination of the symptoms, recommends certain tests to identify the exact cause and plans the right treatment.

Conclusion

Fistulas, abscesses, and piles might look alike, but they have different patterns and require different treatment approaches. If you experience unusual symptoms near your anal region, don’t wait or ignore them.
Book your appointment with the best fistula surgeon in Kolkata, Dr. Purnendu Bhowmik, for an expert and confidential evaluation. The sooner you know what you’re dealing with, the sooner you can get back to living a normal, comfortable life.