Bleeding, pain or discomfort around the anal area can be distressing, and it is natural to be hesitant about seeking medical attention. However, these symptoms are far more common in Singapore than many realise. Around 1 in 10 people in Singapore will experience an anal fissure in their lifetime, and approximately 1 in 4 patients with an anal abscess may go on to develop a fistula.
While these conditions share some similar symptoms, they are distinct medical issues that require different approaches to treatment.
An anal fissure is essentially a small tear or crack in the thin, moist tissue (mucosa) that lines the anal opening. The anal canal is surrounded by a ring of muscle called the anal sphincter, which controls bowel movements. When this muscle goes into spasm due to pain from a fissure, it can reduce blood flow to the area, making healing more difficult and creating a cycle of pain and delayed recovery.
Common signs of anal fissure include:
An anal abscess is a painful collection of pus that develops in the tissues around the anus and rectum. The anal canal contains several small glands that can become blocked, creating an environment where bacteria can multiply rapidly. When this happens, the body's immune system responds by sending white blood cells to fight the infection, resulting in the formation of pus-filled cavities.
Common signs of anal abscess include:
An anal fistula is an abnormal tunnel or tract that forms between the anal canal (inside the rectum) and the skin around the anus. In most cases, fistulas develop as a complication of an anal abscess that has either drained spontaneously or been surgically drained. The fistula creates a permanent connection between the inside of the anal canal and the outside skin, allowing for continuous or intermittent drainage of infected material.
Common signs of anal fistula include:
Getting a diagnosis from a qualified colorectal specialist is crucial for accurately identifying conditions such as anal fissures, abscesses, and fistulas. These issues often share similar symptoms, which makes evaluation essential to avoid misdiagnosis and ensure proper treatment.
In many cases, visible signs are enough for an initial diagnosis. However, when an abscess or fistula is suspected, the specialist may recommend blood tests, imaging studies like an MRI, or a colonoscopy screening. These measures may be necessary to rule out underlying conditions such as Crohn’s disease.
Most diagnostic procedures for eligible conditions are covered by MediSave. For personalised advice, we highly recommend you consult with us or your insurance provider.
Once a diagnosis is confirmed, your specialist will recommend a personalised treatment plan. Since the treatment and management for these conditions differ, it is crucial to listen carefully to your doctor's instructions to ensure proper recovery.
An anal fissure often heals on its own. Stool softeners can help reduce pain during bowel movements, and special medicated creams may be used to promote healing and control symptoms. For fissures that do not heal with these methods, surgery may be necessary.
While antibiotics can help control the spread of infection, they cannot cure an abscess. To properly treat an anal abscess, the pus must be drained from the infected area. This relieves pressure, eases discomfort, and is essential for healing. Complete healing typically takes one to two weeks.
Surgical intervention is typically required to treat an anal fistula. The most common procedure is a fistulotomy, which opens and flattens the tunnel connecting the anal canal to the perianal skin. Following the surgery, it is normal to experience mild to moderate discomfort for a few days, and a full recovery usually takes about four to six weeks.
While anal fissure, abscess, and fistula can cause significant discomfort, they are highly treatable with timely medical attention. A trusted colorectal surgeon in Singapore can provide the care and treatment you need.
If you are experiencing symptoms or simply have questions about your colorectal health, contact us at +65 6518 9838 to schedule a consultation.