Fistula Diagnosis – Tests & Evaluation Process
Anal fistula is a small tunnel that forms between the skin and the anal canal. To treat it correctly, accurate diagnosis is extremely important. Early evaluation helps prevent complications, repeated infections, and recurrence.
Below is the clear and patient-friendly explanation in the same format as your previous blogs:
🔍 What Is Fistula Diagnosis?
Diagnosing an anal fistula involves identifying the location, depth, internal opening, side tracts, and infection level.
A correct diagnosis ensures the surgeon selects the safest and most effective treatment – such as Fistulotomy, LIFT, FiLaC, VAAFT, or Laser Fistula Surgery.
🧪 Tests Used to Diagnose Fistula
1️⃣ Clinical Examination
The surgeon checks for:
- Painful lump near anus
- Recurrent pus discharge
- Swelling or redness
- External opening
- Induration (hard area)
2️⃣ Digital Rectal Examination (DRE)
A gentle internal check to identify:
- Internal opening
- Tract direction
- Infection pockets
3️⃣ Proctoscopy / Anoscopy
A small scope is used to look inside the anal canal.
Helps identify:
- Internal openings
- Associated fissure or hemorrhoids
- Inflammation or abscess
📸 Advanced Imaging Tests
4️⃣ MRI Fistulogram – Gold Standard
MRI gives a detailed 3D map of the fistula.
Shows:
✔ Primary & secondary tracts
✔ Internal opening
✔ Horseshoe extensions
✔ Hidden abscess collections
✔ Involvement of sphincter muscles
Essential for complex or recurrent fistulas.
5️⃣ Endoanal Ultrasound (EAUS)
Used to evaluate sphincter involvement.
Helpful for:
- Intersphincteric and low trans-sphincteric fistulas
- Pre-operative planning
6️⃣ CT Scan (Rarely Needed)
Used only when:
- Severe infection is suspected
- Deep pelvic abscesses need mapping
🟡 Additional Tests (If Needed)
- Blood Tests: CBC, ESR to check infection
- Culture Test: For recurrent pus discharge
- Diabetes Screening: High sugars delay healing
- Colonoscopy: If Crohn’s disease suspected
🚨 Why Accurate Diagnosis Is Important?
✔ Prevents recurrence
✔ Helps choose correct surgery
✔ Avoids sphincter injury
✔ Reduces healing time
✔ Improves long-term outcomes
📍 Fistula Specialist in Thane West – Dr. Ankur Bhanushali
If you experience repetitive pus discharge, pain, or swelling near the anal area, early assessment is important.
🏥 Dr. Ankur Surgical Clinic
📍 Thane West
📞 +91 86910 33066
🌐 bestsurgeoninthane.com
