What Can Happen If an Anal Fistula Is Not Treated: Learning About the Risks and Complications

An anal fistula is an abnormal tract that develops between the skin around the anus and the end of the bowel. It usually occurs when a gland in the anus becomes infected and forms an abscess, which ruptures through to the skin. Although some individuals may be tempted to neglect the symptoms or skip treatment because they are embarrassed or afraid, untreated anal fistula can cause several serious complications. This article discusses what may happen if you fail to receive proper medical attention for this condition.

Progressive Symptoms and Discomfort

When an anal fistula is left untreated, the initial symptoms typically worsen over time:

Persistent drainage from the opening near the anus increases, often resulting in staining of underwear and causing hygiene challenges
Pain levels may fluctuate but generally intensify, especially during bowel movements or when sitting
Skin irritation around the anal area becomes more pronounced due to constant moisture and drainage
Unpleasant odor from the discharge becomes more noticeable and difficult to manage

These symptoms rarely resolve without proper treatment and usually progress to more serious complications.

Recurrent Abscesses

One of the most common complications of an untreated anal fistula is the formation of recurrent abscesses:

The fistula tract allows bacteria to collect and multiply
Periodic blockages in the tunnel can trap infectious material
This leads to repeated painful swelling and abscess formation
Each new abscess episode typically causes more tissue damage
The cycle of abscess-drainage-reformation continues indefinitely without treatment

These recurring infections can be extremely painful, often requiring emergency drainage procedures each time they develop.

Spread of Infection

If an anal fistula is left untreated, the infection can spread beyond the initial area:

The infection may extend deeper into surrounding tissues
Additional fistula tracts can develop, creating a complex network of tunnels (complex fistula)
Infection can spread to other nearby organs in severe cases
Systemic infection (sepsis) can develop in extreme situations, which is a life-threatening condition

The risk of spreading infection increases the longer the fistula remains untreated.

Tissue Damage and Structural Changes

Chronic inflammation from an untreated anal fistula can lead to permanent tissue damage:

The ongoing infection gradually destroys healthy tissue around the anal area
Scarring develops along the fistula tract and surrounding areas
Sphincter muscles that control bowel movements may become damaged
This damage can result in fecal incontinence (inability to control bowel movements)
Once this muscle damage occurs, it may not be fully reversible even with surgery

The longer an anal fistula is left untreated, the greater the risk of permanent structural damage.

Beyond the physical complications, an untreated anal fistula can significantly affect quality of life:

Chronic pain may limit physical activities and work performance
Embarrassment about drainage, odor, or staining can lead to social isolation
Anxiety about potential accidents or discomfort during social situations
Sleep disturbances due to pain or discomfort
Sexual dysfunction related to pain or embarrassment
Depression from dealing with a chronic, unresolved condition

Many people underestimate these quality-of-life impacts when deciding whether to seek treatment.

Increased Treatment Complexity

Perhaps most importantly, delaying treatment for an anal fistula typically makes the eventual treatment more complicated:

Simple fistulas can become complex with multiple tracts
What might have been a relatively straightforward surgical procedure becomes more extensive
The success rate of treatment decreases as complexity increases
Recovery time and post-operative complications increase
Multiple surgeries may be required instead of a single procedure

Early treatment generally leads to better outcomes and simpler procedures.

Conclusion

Untreated anal fistula heals very rarely by itself and virtually always develops advancing complications ranging from chronic pain to severe infection and irreversible damage to the surrounding tissue. If you have a suspected anal fistula, then visiting a doctor and a colorectal specialist soon enough is most important for the prevention of possible complications and attaining the most desirable outcome.