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fistula treatment in india


When any abnormal connection is formed between any two body parts, it is called a fistula. There are several reasons for the formation of fistula including surgery, injury or even any infection.

Fistulas can form in different parts of the body such as a vein and artery, the colon and your body surface, the anus and the skin, etc. The most common type of fistula is an anal fistula where the glands inside the anus are blocked. This leads to an abscess that develops into a fistula.

The formation of a fistula can lead to extreme pain and discomfort. Seeking early fistula treatment is a must to prevent any complications.


Depending on the type of fistula, the symptoms vary. Common fistula symptoms include pain and discomfort in the affected area. Besides this, there are other symptoms that you should watch out for:

  • Irritation and redness in the skin in affected areas.
  • Throbbing pain that is persistent.
  • In the case of anal or vaginal fistula, a foul-smelling discharge is observed.
  • Fever
  • Pus and blood
  • In the case of anal fistula, difficulty in passing stools accompanied by bleeding.

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There are several fistula causes and the treatment varies accordingly. The common causal factors are:

  • Bacterial infection in the affected area
  • HIV
  • Tuberculosis
  • Trauma to the affected area
  • Surgery
  • Health issues like Crohn’s disease, irritable bowel syndrome and colon cancer.

Fistula diagnosis and treatment varies as per the causal factor. In some cases, there could be an underlying health issue that needs to be addressed first to remove the fistula.


If the above-mentioned fistula symptoms are persistent, you need to seek medical attention immediately. Fistula diagnosis begins with a simple physical examination that first requires you to answer a few questions pertaining to the duration of the symptoms, the type of symptoms and irregularities in bowel movements in case of an anal fistula.

  • For external fistula like the ones that are anal, your fistula specialist carries out a physical examination. This is followed by a rectal examination.
  • A special telescope called the proctoscope may be used to view the anal canal and examine it thoroughly.
  • For internal fistula, MRIs, CT Scans, and Ultrasounds are most commonly used.

Fistula treatment usually involves surgical removal of the fistula. There are two common surgical processes that are used in the treatment of fistula:

  • Fistulotomy: The internal opening of the fistula is cut and the infected tissue is scraped out. The channel is then flattened and stitched in place. If the fistula is more complicated or advanced, some tissues from the channel may also have to be removed. The procedure is performed in two stages when a large portion of the sphincter needs to be cut or if it is hard to locate the channel.
  • Advancement rectal flap: This procedure is useful in reducing the removal of the sphincter muscle. A flap is created from the wall of the rectum before the internal opening of the fistula is removed. Then, this flap is used to cover the area that has been repaired.
  • Seton procedures: A thin piece of seton, silk or latex surgical thread is placed inside the fistula and left in place for several days. This helps the fistula heal before any other procedure is carried out if required.
  • Fibrin glue and collagen plug: The channel is cleared and the internal opening is closed with stitches. A special type of glue made using fibrin, a type of protein is injected through the external opening of the fistula. The tract of the anal fistula may also be closed with the collagen plug before closing it.
  • Ligation of the Intersphincteric Fistula Tract or LIFT: This treatment takes place in two stages. It is ideal for deep and complex fistula. First, a seton is placed into the tract of the fistula, forcing it to become wider over time. After several weeks, the infected tissue is removed and the internal fistula opening is closed. WIth is process, the surgeon can avoid cutting the sphincter muscles by accessing the fistula between them.

FiLAC or Fistula Tract Laser Closure: A laser beam is used to remove the fistula completely. Then a 360° laser emission is used to seal the opening of the fistula. This is a minimal access, pain-free alternative to traditional surgical procedures.

In most cases, you need not stay overnight at the hospital. Make sure that you take the pain-killers and antibiotics prescribed by your doctor to prevent infection.

In the case of external fistula such as anal fistula, a warm soak is very beneficial in reducing the pain. Follow up with your fistula specialist after 1-2 weeks to make sure that you are healing well.

Preventive measures of fistula include treatment of any infection or injury completely to avoid the formation of the fistula. Anal fistula prevention includes eating a diet that is rich in fibre, drinking plenty of fluids and keeping the area clean and dry.

  • Minimal access procedures
  • Short duration of procedures
  • Faster healing
  • Zero scarring
  • Painless surgical options
  • Short or no hospital stay
  • Skilled doctors from Safdarjung and AIIMs
  • Early rejoin of work

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