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Anal Fistula Recovery

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By Yolanda Smith, B.Pharm.Reviewed by Dr. Liji Thomas, MD

Surgery is required in the vast majority of cases of anal fistula. It is usually a simple
procedure that can be undertaken in day surgery, and most patients can return home
shortly after the operation.

This article outlines the stages of recovery of anal fistula, including the different areas of
care that patients may require after surgery.

Wound Care
Most patients will need a dressing over the surgical incision following the surgical
procedure while the wound heals. The dressing needs to be changed regularly, so it is
important that they understand how they can do this themselves at home.

To wash the wound, patients can use warm water and soft gauze pads to wash the skin,
making sure to softly pat the skin dry rather than rubbing. Perfume, talcum powder and
other potentially irritating products should be avoided. In some cases, the use of a bland
barrier cream in this area is recommended to prevent irritants from reaching the skin.

There may be some bleeding or discharge from the wound, especially when patients go
to the toilet, particularly in the first couple of weeks after surgery. Some patients find
that it is helpful to wear a sanitary towel or a soft gauze pad inside their underwear to
avoid staining of clothes during this time.

Most wounds take around six weeks to heal, and there will likely be follow-up
appointments during this time to monitor the healing process and check that it is going
well.

Medications
Patients may need to take several different types of medication for a short period after
the surgery to manage or prevent pain, constipation and infections.

Simple analgesics such as paracetamol or ibuprofen are a good choice to relieve pain
after the anesthetic from the procedure has worn off. It is best to avoid opioid
medications such as codeine, which can cause constipation. Non-pharmacological
techniques such as a sitz bath may also help to relieve pain. Do not take over-the-
counter pain medication if you are on prescription medication for pain. Pain medication
may be taken a quarter of an hour before going to the toilet to ease the pain of
defecation in this period.

Fiber and bulk laxatives are useful to assist in regular emptying of the bowel and
prevent constipation, which can put stress on the operated area.
Prophylactic antibiotics may also be indicated to reduce the risk of infection in the area
before and after the procedure.

If you are on any other regular medication for other health conditions, make sure you
know whether you should continue them, or if you need to stop them, for how long.

Resting and General Precautions

It is important that patients are able to rest for several days following the surgical
procedure. During this time, they should allow their bodies to recover, and avoid sitting
or walking for too long.

Many people find it more comfortable to wear loose-fitting clothes during the recovery
period. They may prefer to lie on their side, using pillows or cushions to relieve the
pressure on the rectal area.

Depending on the type of surgery and their workplace, patients will need to stay at
home for a varied amount of time. Most people may return to work and start gentle
exercise as and when they feel able to, usually after several days. Driving and other
activities such as operating heavy machinery should be avoided for at least 48 hours
after the surgery. Patients should be advised to avoid swimming until the wound has
healed completely.

Patients may feel some pain as well as bleeding from the wound when they go to the
toilet. This is alleviated by ensuring that stools are soft and regular, using appropriate
medications or supplements. A good position on the potty is with your feet on a low
stool as it opens up the rectum and makes the passage of stool easier.

Regular mild exercise is advisable starting as early as possible for its benefits on your
emotional and physical health. Regular showering, sleeping and rest will help your
recovery.

A diet which is not overly oily or spicy, and is high in fiber, with plenty of clear fluids, will
help achieve regular soft stools.
When Patients Should Seek Advice
When patients go home following surgery, it is important that they have a clear idea of
what to expect and what they should do if they experience worrying symptoms. They
should be aware of the following signs and seek medical advice if they notice them:

 Heavy bleeding from wound

 Increasing pain, inflammation or discharge
 Nausea or vomiting
 Constipation (no bowel motion for 3 days or more)
 Difficulty passing urine
 Fever
 Redness, swelling or pain in the anal region
 Swelling of the lymph nodes in the groin
 Lack of bowel control

If these symptoms present, patients should see a doctor as soon as possible to discuss
their concerns, and decide upon the appropriate action.

References
 http://www.nhs.uk/Conditions/Anal-fistula/Pages/Recovery.aspx
 https://www.fascrs.org/patients/disease-condition/abscess-and-fistula-expanded-
information
 http://www.guysandstthomas.nhs.uk/resources/patient-information/gi/recovering-
after-anal-fistula-operation.pdf
 https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?h
wid=ud1325

Further Reading
 All Anal Fistula Content
 Anal Fistula: An Overview
 Anal Fistula Diagnosis
 Anal Fistula Symptoms
  Anal Fistula Treatment

More...

Last Updated: Feb 26, 2019

Currently rated 3.7 by 28 people

Written by
Yolanda Smith
Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has
experience working in both Australia and Italy. She is passionate about how medicine, diet and
lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to
explore the world and learn about new cultures and languages.

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Read in:
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Citations
Comments

1. Hi, I am 24 years old. I have had an anal fistula after six months and I

Beko Kurdish says:

July 22, 2017 at 10:34 AM
Hi, I am 24 years old. I have had an anal fistula after six months and I have always cleaned it up
every day. But I felt a slight pain in the area of the wound almost a week later, but I was afraid of
something else at the bottom of the wound. A long time comes out of something like water or
 sweating with a very mild smell I went to a doctor told me it is very good I do not know what to do
and why come out of this thing like water There is no bleeding or pus and also I have constipation
When I go to the bathroom Please tell me what to do Do you need another process

0 0
Reply

2. Hi I am 39 years of age 4 years ago I had a fistula in ano surgery done

Veronique Mitchell says:

August 6, 2017 at 12:55 AM
Hi I am 39 years of age 4 years ago I had a fistula in ano surgery done I am still having some
discomfort after walking or standing for long periods of time the area on the opposite side becomes
swollen and irritated . Is it possible that this should occur?

0 0
Reply

The opinions expressed here are the views of the writer and do not necessarily reflect the views and
opinions of News-Medical.Net.

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