Signs of a Rectal Fistula


A rectal fistula is a condition that can be somewhat embarrassing for some patients to discuss. An individual may realize there is a problem, but is reluctant to bring it up to a physician. If a rectal fistula is not treated, it can lead to even more of a severe problem that might have been avoided.

Definition & Causes

A fistula is actually similar to a small tunnel. It can spread from, in this instance, the rectum up to the skin surface. It also could channel through from the rectum to the vagina in females. If that happens, surgery may be necessary to fix it. Fistulas can be caused from several different things, including birth defects, injury or trauma to the area, an infection in the body, disease such as Chron's disease or cancer, cancer treatment, or even trauma to the area during birth (for females). Sometimes the fistula may start out as an abscess and then rupture, causing the tunnel-like fistula to start.

Signs & Symptoms of Abscess

If the fistula starts out as an abscess, the patient may have quite a bit of pain with any sort of exercise, even with sneezing or bearing down. If the abscess is not near the surface or if it becomes infected, the patient may experience fever and pain in the stomach area. He may also have anal leakage.

Signs & Symptoms of Fistula

If the problem is a rectal fistula, the patient will know, because in most cases, pain is a number one complaint, especially pain with stool passage. The fistula itself may be red, and if it is infected, it may have pus oozing or draining from it. The tunnel can also feel like a cord underneath the surface of the skin; there may even be more than one entrance to the tunnel.


If the fistula goes through to the vagina, the patient may experience problems making it to a bathroom in time; since fecal matter may contaminate the area, infections of the vagina or urinary tract may recur. Pain may be present during sex as well. Also, discharge from the vagina may be more excessive, and the person will emit gas through the vagina.


To find a rectal fistula, the doctor may use a scope to determine the location and size; he may also be able to feel it if it is near the surface of your skin. In order to determine what caused it, he may order a colonoscopy. This will allow him to go farther up into the colon and see if there is evidence of disease.

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