Where is the external opening of an anal fistula usually located?

Nov 14, 2025 Source: Cainiu Health

Dr. Li Jingxiang

Introduction

In general, the location of the external opening of an anal fistula depends on the specific type of fistula, as different types have different external opening positions. If abnormal symptoms occur, it is recommended to seek medical attention promptly. When an abnormal opening around the anus, recurrent pus discharge, or pain is noticed, timely medical evaluation is necessary to establish a clear diagnosis. Daily maintenance of cleanliness and dryness in the anal area is important, and squeezing the external opening should be avoided to prevent infection from spreading. Self-medication should not be attempted, as it may delay proper treatment.

In general, the location of an external anal fistula opening depends on the specific type of anal fistula, as different types have varying external opening positions. If abnormal symptoms occur, prompt medical consultation is recommended. Detailed analysis is as follows:

The position of the external opening of an anal fistula is closely related to the course of the fistula tract, the location of the internal opening, and the extent of the lesion. Due to differences in pathological structure, different types of anal fistulas exhibit distinct patterns in external opening distribution. Low anal fistulas have relatively shallow tracts, mostly located in the perianal skin close to the anal margin. They often form after spontaneous rupture or drainage of a perianal abscess, with typically a single, clearly visible external opening. High anal fistulas have more complex tract pathways that may extend beyond the levator ani muscle; their external openings may be located farther from the anal margin, even appearing in areas such as the buttocks or perineum, and sometimes accompanied by multiple external openings. Complex anal fistulas, which involve multiple branching tracts, tend to have numerous external openings widely distributed, forming intricate connections with internal openings.

When detecting abnormal openings around the anus, recurrent pus discharge, or pain, timely medical evaluation is essential for accurate diagnosis. Daily care should include maintaining cleanliness and dryness of the perianal area. Avoid squeezing the external opening to prevent infection spread. Do not self-medicate, as this may delay proper treatment. Professional examinations are necessary to determine the type of anal fistula and provide a basis for subsequent management.

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What ointment is good for cleaning an anal fistula wound?

In general, wound care after anal fistula surgery requires the use of ointments that have both anti-infective and healing-promoting properties. Patients may use medications such as mupirocin ointment, compound polymyxin B ointment, recombinant human epidermal growth factor gel, Longzhu ointment, or Kangfuxin solution as directed by their physician to aid recovery. Before applying medication, ensure the wound is clean, and rinse the perianal area with warm water after each bowel movement.

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What are the causes of bleeding in anal fistula?

Bleeding from an anal fistula may be caused by bowel movement irritation, local friction, fistula infection, perianal abscess, or perianal eczema. It can be improved by adjusting bowel movements, reducing irritation, and medication. If bleeding increases or is accompanied by severe pain, prompt medical attention is necessary. Hard, dry stool passing through the area of the anal fistula can cause friction against the fistula's mucosal lining, leading to tissue damage and bleeding.

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What causes the wound to turn white after anal fistula surgery?

In general, whitening of the wound after anal fistula surgery may be caused by normal granulation tissue, local moisture maceration, wound infection, ischemia, or false healing. If any discomfort occurs, it is recommended to seek timely medical evaluation and treatment at a reputable hospital. Maintain a light and easily digestible diet, consume more protein-rich foods, keep bowel movements smooth, and avoid constipation that could lead to straining and wound tearing.

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What medication should be taken after anal fistula surgery?

In general, medication after anal fistula surgery aims to prevent infection, relieve pain, promote wound healing, and maintain smooth bowel movements. Patients may follow their doctor's instructions to use medications such as cefdinir dispersible tablets, ibuprofen sustained-release capsules, kangfuxin liquid, lactulose oral solution, and compound alginates suppositories for treatment. It is also important to develop regular bowel habits and consume more foods rich in dietary fiber.