Recovery

Anal fistula treatment

An anal fistula is treated with surgery under general anaesthetic.

Most people can leave hospital on the same day as surgery.  

You need a friend or family member to travel home and stay with you for at least 24 hours after your surgery. It is important that you rest for the rest of the day.

If your fistula is complex (branches in different directions) you might need to stay in hospital overnight. 

Dressings

You might have a dressing over your wound. This can be removed, in a bath, the day after your surgery. You might need to give the dressing a gentle pull to take it off. This can cause your wound to bleed. Do not be worried if this happens, you can contact us if you have any concerns. 

Looking after your wound

Keep the area clean and gently bathe your wound in a warm bath each day, if possible. This can also help with your pain. Do not use soap, or put salt or any perfumed products in the water until your wound has healed, as these could irritate your wound.  

Try to wash the area or use alcohol-free wet wipes to clean your wound after going to the toilet to have a poo.  

Your surgeon may ask you to ‘digitate’ your wound. This means running a finger along your wound to prevent the top layer of skin from healing too quickly. This might be uncomfortable, but can help to stop your fistula from coming back. If you do not wish to do this yourself or cannot reach the area, you will need to ask your GP’s practice nurse to do this each day. 

If you have had a seton stitch inserted, you might find that some mucus (thick, slippery fluid) leaks out of the wound. This is normal. You might wish to wear a pad in your underwear and bathe more often, as the mucus can cause the surrounding area to become sore and itchy. 

Your nurse will give you instructions about caring for your wound. 

Speak to the ward or department where you were treated if:

  • you have persistent bleeding from your wound 

Out of hours, contact your GP or go to your nearest emergency department (A&E). 

Ask for an urgent GP appointment or go to the nearest A&E if:

  • you feel generally unwell
  • have a high temperature (fever) 

Pain after surgery

You should expect some discomfort. It can be quite painful for the first couple of days, and it might seem like the pain gets worse before it starts to feel more comfortable again. 

You might have some discomfort and a little bleeding the first time you go to the toilet to have a poo. You should try to go the toilet when you get the urge to. It can help to take painkillers about 15 to 20 minutes before you have a poo, to reduce the discomfort.  

When you leave the ward or day surgery, you might be given the following to take home with you.

Painkillers

It is important that you take your prescribed amount (dose) of painkillers regularly, to keep you as comfortable as possible. You might not need to take them if you are not in pain. Always follow the instructions on the packet and never take more than the recommended dose.

Antibiotics

We might give you antibiotics to prevent infection and reduce your pain.

If you are given antibiotics called metronidazole (Flagyl®), do not drink alcohol while you are taking the tablets. These tablets can cause unpleasant reactions if mixed with alcohol, such as:

  • feeling and being sick (nausea and vomiting)
  • flushing of the face
  • headaches
  • heart palpitations

You can safely drink alcohol again 2 days after finishing your course of metronidazole. 

Always complete the prescribed course of any antibiotics. Tell your doctor if you are allergic to any antibiotics and always ask if you are not sure about any of your medicines.

Laxatives

You might be given laxatives to help you go to the toilet. Laxatives encourage bowel movement and help to keep your poo soft. 

Returning to work and normal activities

Most people take a few days off work, but this depends on how you feel and how active your job is. 

Do as much as you feel able to, but avoid any strenuous activity such as lifting, exercise or running during the first week or so.  

You should not go swimming until your wound has healed. You can have sex as soon as you feel comfortable.

Follow up appointment

Anal fistulas can be difficult to treat and heal. It is important you go to your follow-up appointment. This is usually about 4 to 8 weeks after your surgery. 

At this appointment, the specialist will check your wound and seton stitch (if you have one). They will make sure that no other abscesses or fistulas are developing. They will also discuss with you whether you need more surgery. 

If you have not been given an appointment within 2 to 3 weeks of your surgery, please call us to book an appointment.

Resource number: 0908/VER5
Last reviewed: March 2022
Next review: March 2025

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