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Why Does My Fistula Keep Coming Back? Here is What You Need to Know

Have you undergone surgery for an anal fistula, only to find that it came back again? You are not alone. Many patients feel frustrated and hopeless when the problem recurs after one or even two surgeries. At Karan Hospital, we understand how emotionally and physically draining this condition can be. In this blog, we will explain why fistulas return, how they form, and what you can do to find lasting relief.

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What is a Fistula-in-Ano, and Why Does It Happen?

The anal canal is one of the most infection-prone areas of the body. It contains tiny glands on either side, just inside the anus. These glands help secrete mucus, but sometimes, a stool particle or mucus plug can block a gland, especially in people with constipation or hard stools. Once blocked, bacteria quickly multiply and form an abscess—a pocket of pus. If this abscess is not completely drained or bursts on its own, it creates a small tunnel under the skin called a fistula. This tunnel connects the infected gland (inside the anus) to the skin surface outside. And if not treated completely including all extensions, branches, and the internal opening the fistula may keep coming back.

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Why Does a Fistula Keep Coming Back After Surgery?

Many patients ask: "Doctor, I've already had surgery. Why is the fistula back again?" Here are the most common reasons:

  • 1. The Full Tract Was Not Treated: Fistulas often have hidden branches or deep extensions, especially in complex or recurrent cases. If any part of the tract is missed during surgery, the infection remains inside and reactivates later.
  • 2. Internal Opening Was Missed: The root of every fistula is its internal opening in the anal canal. If this opening is not closed or properly treated, infection continues to leak into the tract even if the outer wound heals temporarily.
  • 3. Complex or High-Level Fistula: Some fistulas pass above or through the anal sphincter muscles, or even reach up to the supralevator space. These require advanced imaging (MRI) and specialized treatment like laser surgery, coring techniques, or staged procedures. Simple surgeries may not be effective here.
  • 4. Poor Healing or Underlying Conditions: Patients with diabetes, weak immunity, smoking habits, or poor wound care may not heal properly. This can also lead to recurrence despite good surgery.
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What is the Solution for Recurrent Fistula?

At Karan Hospital, we specialize in minimally invasive, sphincter-saving treatments for complex and recurrent fistulas. Here is how we approach it:

  • Accurate Diagnosis with MRI: We always start with an MRI to map the full fistula tract, including hidden branches, abscesses, and internal openings.
  • Tailored Treatment Approach: Depending on your fistula type, we may use:
    • Laser
    • Fistula Tract Coring (ProctoCor)
    • VAAFT (Video-Assisted Anal Fistula Treatment)
    • LIFT Procedure
    • Seton Placement and Staging
  • Expertise in Complex & Recurrent Cases: Many of our patients come to us after failed surgeries elsewhere. We focus not just on removing infection, but on healing the disease completely, technically and biologically.

In Simple Words: It is Not Your Fault – Fistulas recur not because you did not follow post-op care, but because the disease is deep, complex, and tricky. It requires an experienced eye, modern tools, and personalized care.

In Simple Words: It is Not Your Fault

Fistulas recur not because you did not follow post-op care, but because the disease is deep, complex, and tricky. It requires an experienced eye, modern tools, and personalized care.

Still Struggling With a Recurrent Fistula? Let Us Help.

At Karan Hospital, we combine the latest techniques with years of experience treating all types of fistulas, including those that have returned after surgery.