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How Do I Treat a Fistula with Pus?

By Erin J. Hill
Updated: Mar 03, 2024

The primary treatment for a fistula with pus is antibiotic medication and, often, surgery. Most fistula surgeries are uneventful, and they heal quickly. Some patients may not realize they have a fistula until additional issues, such as abscesses, develop. Most fistulas occur due to a previous abscess, although they may not appear until many months later. By this time, patients may not realize what is going on with their bodies until a medical professional checks them.

A fistula is a tunnel, or passage, beneath the skin. It usually runs from one gland to another within the anal or rectal cavity. Most fistulas are formed when someone has an abscess on or around the anus. An abscess is a skin infection which usually leads to a large pimple-like skin eruption. Eventually, the area will open up and drain pus. Abscesses are often very painful until this drainage occurs. Sometimes a fistula can also occur higher up in the intestines, in the urinary tract, or around the genitals.

Sometimes after an abscess drains, the area beneath it remains open and creates a tunnel underneath the skin. This tunnel connects glands, pores, and other open areas of tissue. Bacteria can travel easily within this tunnel, and additional abscesses may occur. The passage, or fistula, may drain pus continuously, or it may be closed off after awhile and recurrent abscesses might result.

Fistulas are officially diagnosed through diagnostic tests such as colonoscopy. If the fistula with pus is suspected in the urinary tract or vagina, x-rays may be performed to secure a diagnosis. If there is no active infection, medication may be given as a first line of defense for a fistula. Antibiotics are the most common, as they can help kill any infectious bacteria found in the urinary, reproductive, or digestive tracts.

Treatment of for a fistula with pus is usually surgery. The area of skin where the tunnel is located will be cut out and fully removed. This is usually around the rectum or lower anus. Smaller fistulas can often be taken care of as an outpatient procedure, although some larger ones are removed in the hospital. Recovery time is generally short, and patients can be get back to their normal routines within a matter of days in most cases.

It can be hard to recognize a fistula with pus for what it is. Sometimes a fistula will not become apparently until weeks, or even months, after the initial infection. Patients may notice pain around the rectum or in the anus, and they may experience chills, fever, and discomfort. Having bowel movements may also be uncomfortable, and pus often drains out of the rectum. These symptoms can be worrisome, and patients are urged to see a doctor if they notice anything out of the ordinary.

Sometimes a fistula with pus will occur at the same time as additional abscesses. Once a skin infection takes hold, it can be difficult to get rid of it entirely. This is especially true if the first abscess was not properly or entirely drained. Those with severe or recurrent abscesses may require continued treatment. Surgery to remove both the abscess and the fistula may be needed.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
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Discussion Comments
By burcinc — On Dec 02, 2013

I used to have a fistula that was getting re-infected periodically. Around that time, I was diagnosed with Crohn's disease and started getting treatment for it. The fistula reduced in size and the antibiotics became more effective after that. So it's a good idea to treat underlying conditions too.

By literally45 — On Dec 01, 2013

@SarahGen-- Has she had an x-ray? She might need to go ahead with surgery and let the doctor look for the fistula in the process. That's what happened to me and they ended up finding two!

Unfortunately, fistula surgery is painful too. I was in a lot of pain and I had multiple surgeries. An opening was left with a string for each fistula after my initial surgery to let the pus drain. I had to go back to have those removed and to get stitched after a few months.

It all turned out well though. I'm two years post operation and I'm completely fine now. Unfortunately, there is no easy way to treat infected fistulas because they only show symptoms when things have gotten quite bad.

By SarahGen — On Dec 01, 2013

My sister probably has a fistula. That's what her doctor suspects because she has all the symptoms -- pain and pus from the anal area. But they haven't been able to find the fistula yet. She has had a few diagnostic tests and was put on oral antibiotics which helped for a little bit. But her symptoms are back now and she's back at the doctor's office. I hope they find the fistulas and remove them soon. The poor thing is suffering.

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