Fistula is a disease, this is an infective disorder. What happens is there is something called as anal glands which will be in between the anal sphincters or different areas around the anus. So they will be secreting little secretions into the anal canal to keep it moist, for lubrication purpose there are many glands so when there is constipation or when there is a lot of friction in that areas the glands get infected and then pus will form and when pus forms, we call it and abscess and that causes pain. Then either it opens into the anal canal through the glands duct and it will be secreting inside and the discharge will be coming from inside the anal canal and then we call it as a sinus or if the pus comes outside thorough anal canal through small openings, we call as external openings, we call it as fistulas. Fistulas as tract with one external opening and internal opening and in between that pus will be formed, whenever we detect fistula there is medical line for fistula. Very early stage of abscess even before it has formed abscess, very minimal infection we and give antibiotics and medical line of management but once pus has formed it has come out, it makes its own opening and come out, what we call as a fistula or a surgeon will open it, drain it properly an d clean it to prevent formation of fistula. So once a fistula is formed, there is no medical treatment for curing fistula. Now if we don’t treat a fistula, if we don’t do a surgery for fistula, there are 2 consequences. There are 2 types of fistula. One is a simple fistula where there is a single tract, with a lower openings and only tract is there which is easy to operate and the recurrence rate is very minimal. So that is the stage if it is treated it is cured. Practically it is a curable condition. But if you don’t treat it for long, what happens is this pus will starts spreading to different areas between t he sphincters, crossing the sphincters above the sphincters, outside the sphincters it can spread to different areas, and then we call it as complex fistulas, where the surgery is risky, the damage to the sphincters are possible and recurrence rate goes up very high. So if we don’t treat fistula it is little bit complex fistula. In extremely rare cases, there are repsors that some of the fistulous tracts left for many many years can become malignant or turn into cancers. Sometimes cancer in that area can present as fistula or some other diseases like tuberculosis or Crohn’s diseases, they all present like fistula, but if we treat it like a simple fistula then that disease can spread and cause a havoc. So always the movement we detect a fistula, we have to plan for the treatment and aim for the sure of the disease. So delaying the treatment of fistula doesn’t make any sense.

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