Is It OK to Live with an Anal Fistula?

An anal fistula is an abnormal tunnel connecting the anal canal to the skin surface near the anus. It typically develops from an infection that starts in an anal gland, forming an abscess that eventually breaks through to the skin. Many people wonder if they can simply live with this condition rather than pursue treatment. This article explores whether living with an anal fistula is a reasonable option and what you should consider when making this decision.

Understanding the Reality of Living with an Anal Fistula

Living with an anal fistula means managing several ongoing symptoms and challenges:

Daily Symptoms You May Experience

Drainage: Most anal fistulas continuously or intermittently drain pus or fluid, requiring protective pads or frequent clothing changes
Pain: Discomfort ranges from mild to severe, often worsening during bowel movements
Irritation: The surrounding skin may become red, tender, and irritated from constant moisture
Odor: The drainage typically has an unpleasant smell that can be difficult to mask
Itching: Chronic wetness around the area often causes persistent itching

Impact on Daily Life

The practical challenges of living with an anal fistula include:

Difficulty sitting for extended periods
Interference with work activities and productivity
Limitations on physical activities, including exercise
Embarrassment in social or intimate situations
Sleep disruptions due to discomfort
Constant concern about leakage or odor

Potential Risks of Not Treating an Anal Fistula

Choosing to live with an anal fistula without treatment carries several significant risks:

Physical Complications

Recurring Abscesses: The infection can periodically block and build up, forming painful abscesses that may require emergency drainage
Spreading Infection: The infection can spread to surrounding tissues, creating more extensive damage
Complex Fistulas: Simple fistulas can develop additional branches over time, becoming more complex
Muscle Damage: Long-term inflammation can permanently damage sphincter muscles, potentially leading to fecal incontinence
Systemic Infection: In rare cases, an ongoing infection can enter the bloodstream, causing a serious systemic illness

Quality of Life Deterioration

The longer you live with an anal fistula:

The more the condition typically impacts your daily functioning
The higher the likelihood of developing anxiety or depression related to the condition
The greater the potential for relationship difficulties due to the condition

When Living with an Anal Fistula Might Be Considered

While medical treatment is generally recommended, there are limited circumstances where managing rather than eliminating an anal fistula might be discussed:

Extremely Low Symptoms: Some very minor fistulas cause minimal drainage and discomfort
High Surgical Risks: People with certain medical conditions might face increased risks from surgery
Complex Medical Situations: Those with conditions like Crohn’s disease may have recurring fistulas despite treatment
Temporary Delay: Short-term management while preparing for surgery or addressing other health priorities

Even in these cases, the decision should be made in consultation with a colorectal specialist, not independently.

Management Strategies If Treatment Must Be Delayed

If treatment must be postponed or if you’re considering living with the condition, these strategies may help manage symptoms:

Sitz Baths: Regular warm water soaks to clean the area
Proper Hygiene: Gentle cleaning after bowel movements
Protective Pads: Absorbent pads to prevent staining
Pain Management: Over-the-counter pain relievers as recommended by your doctor
Fiber Supplements: To soften stools and reduce discomfort during bowel movements
Regular Medical Monitoring: Continued check-ups to watch for worsening conditions

The Bottom Line: Is It OK?

While it’s physically possible to live with an anal fistula, medical professionals generally don’t recommend it as a long-term strategy. The condition:

Rarely heals without proper treatment
Typically worsens over time
Can lead to serious complications
Significantly impacts quality of life
Often becomes more difficult to treat the longer it persists

Most colorectal specialists would advise against indefinitely living with an anal fistula when treatment options are available. Modern surgical techniques have improved significantly, with many procedures being minimally invasive and offering success rates with reasonable recovery times.

If you’re concerned about treatment, consulting with a specialist about your specific situation and exploring all available options is the wisest approach.