Stages of Fistula

A fistula does not follow strict stages, but it commonly passes through a recognisable sequence.

Stage 1: Blocked gland and infection

A gland in the anal canal becomes blocked and infected. There may be pain and mild swelling.

Stage 2: Abscess

Pus collects near the anus. There is throbbing pain, a hot, tender swelling and sometimes fever. This is a surgical problem and often needs drainage.

Stage 3: Drainage

The abscess bursts or is drained. Pain eases, but an abnormal tunnel may stay behind.

Stage 4: Established fistula

A tunnel (tract) runs from the inner opening in the anal canal to an external opening on the skin. It discharges on and off and may block and form new abscesses.

Stage 5: Recurrent or complex disease

Without proper treatment, the tract can branch, extend, and become more difficult to treat. Repeated infection scars the tissue.

What does not happen

Established fistulas rarely heal by themselves for good, because the tunnel stays lined with scar tissue and keeps connecting to the anal canal.

What this means in practice

• Seek care at the abscess stage; early drainage prevents spread.
• Seek assessment for any persistent discharge near the anus.
• Treatment is planned according to the tract and the muscle involved.

Ayurvedic framing

Ayurveda describes stages such as the early swelling (pidaka) and the established tract (bhagandara). This is an interpretive framework and does not change the need for surgical assessment.

If you develop severe pain, swelling and fever, get same-day care. Call 112 or 102 in an emergency.