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History of anal fistula. Having pain and pressure below tailbone. Worrisome

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Internal Medicine Specialist
Practicing since : 2000
Answered : 1417 Questions
I have pain presser below my tail bone on the right side of my anus.
I had surgery about 6 months ago for an anal fistula.
But that was at a lower area below my scrotum
Posted Sat, 15 Dec 2012 in Digestion and Bowels
Answered by Dr. Sudhir 33 minutes later

Thanks for the question.

In view of your history of anal fistula and current symptoms, two possibilities seem likely- first is recurrence of anal fistula in different location and second is gluteal infection.

Both of these possibilities are quiet common and known to recur even after surgery.

Anal fistual can occur all around anus, so the previous location may be down below but symptoms higher up can also be due to anal fistula at this location.

I guess an early evaluation by your surgeon is suggest before this progresses or becomes secondarily infected.Doctor will confirm the diagnosis and help accordinly.

Mean while you can take oral analgesics for pain.Avoid wearing tight clothes, sitting in one position for long, keep the region clean, avoid any kind of friction, take seats bath etc.

Hope this answers your question.Please feel free to ask if there are doubts.


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Follow-up: History of anal fistula. Having pain and pressure below tailbone. Worrisome 23 hours later
Why does this keep reoccurring?
The last flare up after surgery was not even a year. The abscess reached the surface on the left side below the scrotum. And the time before that was 3 years, the time before that was about 5 years.
All in the same place and all are requiring surgery. This time the presser is in a total different location nowhere near the others.
I want to know what I can do to keep this from reoccurring. Have surgery every few years and with closer flare up seems like the problem is not being resolved, (just patched up every time if you will)
All the surgeon does is clean it out not keep it from coming back. Could it diet, alcohol not enough fiber, disease etc…?
I am going to see a gastro doctor tomorrow if I can get in, I want to try and avoid surgery the scar tissue is crazy now.
And like I said it is not getting resolved obviously, just patched up temporarily.

Answered by Dr. Sudhir 17 minutes later
Thanks for follow up query.

It's always difficult and also may not be possible to prevent such fistulas from recurring.Because in most cases more stress is given on treatment and factors contributing to formation are not assessed.So even after treatment these factors remain unchanged and lead to fistula.

Other important cause for recurrence is - by nature itself this area is prone for infection, again the excess fatty tissue in this region harbors uncleared infections and antibiotics cannot entirely penetrate this fatty tissue.So doctors are also at limitations.

Few things which can help are -

Keep the region clean,
Save off hair in this region regularly,
Use underwear which don't get excessively wet.
Instead of paper cleaning use water and soap to clean after passing stools.
Using gentle techniques to clean the anal area
Keeping the anal area dry by changing underwear frequently and using powder to absorb moisture
Always using a condom if you practice anal intercourse
Never inserting any foreign object into the rectum.
Loose weight, in obese people buttock cheeks rub with each other.
Avoid body or head hair getting trapped in between buttocks.
All early symptoms should be evaluated.
Avoid tight clothes.
Avoid clothes getting in between buttock cheeks.

Hope this answers your question to some extent.

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