My Anal Fistula Journey: 4 Years of Itching, 3 Months of Pain, Multiple Doctors, 2 Fistulas, and Finally Surgery (35M)
35M here. I just had my fistulotomy after three months of pain, uncertainty, countless medical appointments, and investigations across several countries. I wanted to share my experience because I wish I'd read something like this when everything first started.
I'm extremely active, exercise almost daily, and generally take good care of my health.
This experience completely caught me off guard.
At certain points, the pain was unbearable. Other times, the uncertainty and anxiety surrounding the diagnosis were almost worse than the physical symptoms.
Interestingly, I became virtually pain-free during the week leading up to surgery.
Along the way, doctors also discovered something completely unexpected during my colonoscopy: a precancerous polyp that was subsequently removed.
Here's my story, what I've learned, and what I would tell anyone experiencing similar symptoms.
Disclaimer: This is my personal experience, not medical advice. Everyone's fistula is different.
1. THE WARNING SIGN I IGNORED FOR FOUR YEARS
For approximately four years, I experienced persistent itching on the left side of my anus.
It was incredibly annoying.
The itching would come and go, particularly after exercising, sweating, walking long distances, or experiencing friction around the area.
Sometimes, after bowel movements, I would notice a tiny amount of blood when wiping. Occasionally, what looked like a small cut would appear in exactly the same location. I thought it was probably a minor exercise fissure or from itching from sweat.
I visited a colorectal surgeon, who suspected a fungal infection and prescribed a cream.
It seemed to help temporarily, but the itching always returned.
Over the years, I experimented with zinc oxide, fusidic acid, antifungal treatments, and various other creams.
Eventually, I accepted that I simply had sensitive skin in that area.
I ignored it because I wasn't experiencing significant pain.
Fast-forward four years, and my surgeon eventually identified my symptomatic fistula in that exact location.
I can't prove that the fistula was present for all four years. However, I certainly wish I'd investigated the recurring symptoms more thoroughly.
LESSON #1: If you're experiencing persistent anal itching, recurring cuts in the same location, unexplained discharge, or intermittent swelling, please get properly examined by a colorectal specialist and FORCE AN MRI. I had no idea until i saw the right person to identify my issue.
If your symptoms suggest a possible fistula, discuss whether a pelvic MRI with a fistula protocol would be appropriate.
Don't spend years relying on creams without understanding what's causing the problem.
2. JULY: EVERYTHING STARTED WHILE HIKING IN EUROPE
In July, I was traveling through Europe, hiking mountains and generally enjoying my vacation.
Following a long hike, I started experiencing some incredibly strange symptoms.
The weirdest part?
The pain initially wasn't even concentrated around my anus.
Instead, I experienced:
- Pain radiating into my legs.
- Discomfort around my testicles.
- Lower abdominal pain.
- Pelvic pressure and tightness.
- Tightness in my quadriceps.
- Occasional pain and pressure around my rectal area.
As someone who exercises almost daily, I couldn't understand what was happening.
Was it a muscular injury? A nerve problem? Something involving my prostate?
I started imagining all sorts of possibilities.
I initially visited a hospital in Poland, hoping to get examined. Unfortunately, communication difficulties prevented me from obtaining the assessment I needed.
I continued traveling, hoping the symptoms would disappear.
They didn't.
3. PRAGUE: MY FIRST FISTULA DIAGNOSIS
My next destination was Prague.
By this point, the pain had become incredibly frustrating.
I visited a colorectal surgeon, who examined me and suggested that I had an anal fistula.
Unfortunately, I didn't feel confident about the examination or the explanation I received.
I left with more questions than answers.
For approximately a month, I experienced intermittent episodes of significant pain.
I was taking painkillers, researching symptoms, and trying to continue enjoying my vacation.
Some days were manageable.
Other days were absolutely miserable.
The uncertainty made everything considerably worse.
Eventually, I decided that I needed a more thorough investigation.
4. HOME: AFTER SIX SPECIALISTS AND FINALLY AN MRI
I decided to fly back home and investigate everything properly.
Within approximately a week, I underwent a pelvic MRI and additional medical examinations.
Throughout this experience, I consulted approximately six specialists, including colorectal surgeons, a urologist, and a general practitioner.
Because it was summertime, several doctors were on holiday, which made coordinating appointments particularly frustrating.
Here's where things became interesting.
Multiple doctors couldn't physically identify a fistula during their examinations.
Sometimes there was no obvious external opening, no significant swelling, and no drainable abscess.
Yet I was still experiencing symptoms.
Finally, the MRI results came back.
I HAD TWO ANAL FISTULAS.
Both were described as relatively short, simple intersphincteric fistula tracts.
The MRI didn't identify a major abscess collection.
At last, I had a diagnosis supported by imaging.
The doctors reviewed everything and cleared me to continue traveling. I thought I had cancer, and thankfully i had some headspace.
So I flew back to Europe.
5. GERMANY: ANOTHER EXTREMELY PAINFUL EPISODE
Unfortunately, the problems weren't over.
While traveling through Germany, I experienced another extremely painful episode.
This time, the pain was much more concentrated around the left side of my anus.
I experienced significant pressure, tenderness, and discomfort, alongside pain radiating throughout my pelvic region.
I also noticed what felt like substantial muscular tension around my pelvis.
From my own research, I suspected that some of the discomfort might involve pelvic floor muscle guarding in response to the pain.
I can't confirm that diagnosis, but the muscle tension certainly felt real.
I visited another colorectal surgeon in Germany.
He performed additional examinations, including an ultrasound.
Despite the MRI findings, he couldn't clearly identify an accessible fistula during the physical examination.
He also didn't identify an abscess requiring immediate drainage.
Eventually, I was cleared to continue traveling.
Fortunately, my symptoms gradually started improving over the following weeks.
This brings me to one of the most interesting things I learned throughout this entire experience.
6. THE PSYCHOLOGICAL SIDE OF PAIN
I think this is something that deserves considerably more attention.
Throughout this ordeal, I spent an enormous amount of time researching my condition.
Medical websites. Reddit. Surgical complications. Recurrence rates. Horror stories.
You name it, I probably read it.
Every unusual sensation made me wonder whether I was developing another abscess.
Every episode of pressure made me question whether something worse was happening.
I became incredibly preoccupied with my health.
However, once I understood my diagnosis, received reassuring medical investigations, and developed a treatment plan, something interesting happened.
My anxiety decreased, and I noticed that some of my pain and pelvic tension decreased with it.
I'm absolutely NOT suggesting that fistula pain is imaginary.
My fistulas were real. My infections were real. My pain was real.
But I believe that constantly worrying about the condition and monitoring every sensation amplified my experience.
The human nervous system is incredibly complex. Fear, stress, and muscular tension can influence how we experience physical pain.
Once I stopped catastrophizing every sensation, I started feeling noticeably better.
LESSON #2: Educate yourself, but don't spend every waking hour reading horror stories online.
Everyone's situation is different.
Someone experiencing severe, complex Crohn's-related fistulas may have a completely different experience from someone with a simple, low fistula.
Don't automatically assume that the worst experiences you read online will happen to you.
Take your symptoms seriously, but don't let fear consume your entire life.
7. THE LIFESTYLE CHANGES THAT HELPED ME
Throughout this experience, I decided to focus on the aspects of my health that I could control.
For approximately three months, I completely eliminated alcohol.
I also made several changes:
- Ate a nutritious diet with plenty of vegetables.
- Maintained adequate daily protein intake.
- Increased my fiber intake using psyllium husk.
- Focused on keeping bowel movements soft and regular.
- Maintained proper hydration.
- Continued my usual vitamins and supplements.
- Exercised regularly whenever my symptoms allowed.
- Adjusted workouts that aggravated my pelvic discomfort.
- Focused on improving my sleep and managing stress.
One thing I noticed was that alcohol seemed to make my bowel movements harder and could aggravate the irritated area.
Eliminating it made managing my symptoms easier.
I also continued exercising as much as possible.
I'm not suggesting that anyone should push through severe pain or exercise during an acute infection.
However, maintaining physical activity within my comfort level made an enormous difference to my mental health.
Gradually, my symptoms started improving.
IMPORTANT: I'm not claiming that diet, supplements, exercise, or eliminating alcohol will cure an established anal fistula.
They won't necessarily eliminate the underlying tract.
But improving my overall health and keeping my bowel movements comfortable helped me manage my symptoms and feel considerably better.
8. SEPTEMBER: MORE TESTS AND AN UNEXPECTED DISCOVERY
When I returned home in September, I continued investigating the fistulas and preparing for definitive treatment.
My doctors performed additional blood and stool tests.
Two important results were:
- CRP: 0.60 mg/L.
- Fecal calprotectin: 10.8 µg/g.
Both were reassuring regarding significant active intestinal inflammation.
However, because I had TWO fistula tracts, my doctors wanted to investigate whether I could have Crohn's disease or another form of inflammatory bowel disease.
Consequently, I underwent a colonoscopy.
The examination showed that my colon, rectum, and terminal ileum appeared normal.
This was incredibly reassuring.
However, the colonoscopy also revealed something completely unexpected.
THE DOCTOR FOUND A PRECANCEROUS POLYP IN MY COLON.
It was approximately 4 mm in size.
The doctor removed it, and pathology identified it as a tubular adenoma with low-grade dysplasia.
Fortunately, there was no evidence of cancer or high-grade dysplasia.
For anyone unfamiliar with these findings, certain types of colon polyps have the potential to develop into cancer over time.
Not every polyp becomes cancerous, and there's no way of knowing whether mine would ever have progressed.
But it was a precancerous lesion, and it has now been removed.
Think about that for a second.
Had I never experienced these fistula symptoms, I probably wouldn't have undergone a colonoscopy at 35.
That polyp might have remained undetected for years.
Something that initially seemed like one of the worst medical experiences of my life potentially helped me identify and eliminate an entirely separate health risk.
I'm genuinely grateful for that.
I'll still follow my gastroenterologist's recommendations regarding future surveillance.
But this unexpected discovery completely changed my perspective on the entire experience.
9. DECIDING TO HAVE SURGERY
After reviewing my MRI and other investigations, my colorectal surgeon recommended a fistulotomy.
Interestingly, my two fistulas were behaving very differently.
One was essentially inactive and wasn't causing noticeable problems.
The other was responsible for the recurring irritation, inflammation, and drainage.
My surgeon recommended treating the symptomatic fistula rather than automatically operating on both.
He explained that the procedure involved opening the tract so that it could heal properly.
Based on my particular anatomy, he estimated approximately a 90% success rate.
Obviously, success rates differ depending on the type of fistula and individual circumstances.
But hearing that estimate made me feel considerably more confident.
Then something unexpected happened.
DURING THE WEEK LEADING UP TO SURGERY, I BECAME VIRTUALLY PAIN-FREE.
For the first time in months, I wasn't experiencing the constant discomfort and pressure that had dominated my life.
Even the area that had previously been inflamed seemed much calmer.
I started questioning whether I still needed surgery.
However, after discussing everything with my surgeon, I understood that the absence of pain didn't necessarily mean that the fistula tract had disappeared.
Given my history and the medical findings, I decided to proceed.
10. SURGERY DAY: MY EXPERIENCE WITH FISTULOTOMY
Today, I finally underwent my fistulotomy.
I'm happy to report that the operation went well.
I received spinal anesthesia, which involved an injection into my lower back to numb the lower part of my body.
I was positioned face down for the operation.
Beforehand, I was particularly nervous about the spinal needle.
However, the needles were the most uncomfortable part of my experience and to be honest were not very painful, just uncomfortable.
Once the anesthesia took effect, I didn't experience significant pain during the procedure.
My surgeon completed the planned operation, and I've now started my recovery.
Obviously, it's only day one.
I'm expecting some discomfort once the anesthesia wears off, particularly during bowel movements.
I'll be following my surgeon's postoperative instructions carefully.
I also can't tell you yet whether the operation has been successful in the long term.
However, I'm incredibly relieved that I've finally reached this point.
After months of uncertainty, traveling between countries, visiting specialists, undergoing investigations, and worrying about my health, I've finally had the procedure.
I'm looking forward to getting back to normal life.
I'll try to share updates regarding my recovery, particularly around pain, bowel movements, sitting, exercise, and returning to the gym.
11. MY BIGGEST LESSONS FOR ANYONE GOING THROUGH THIS
If you're currently struggling with an anal fistula, here are the biggest things I've learned.
1. Don't ignore persistent symptoms.
I experienced recurring anal itching and occasional superficial bleeding for approximately four years.
Whether the fistula was present that entire time is impossible to establish, but I wish I'd investigated those symptoms more thoroughly.
2. If your doctors suspect a fistula but can't find it, ask about further investigations.
My fistulas weren't always detectable during physical examinations.
However, the MRI clearly identified two tracts.
Discuss appropriate imaging with your colorectal surgeon if your diagnosis remains uncertain.
3. Understand your specific anatomy.
Not all fistulas are the same.
Some are relatively simple, while others are considerably more complex.
Your treatment options, recovery, and recurrence risks depend on your individual circumstances.
Don't assume that someone else's experience automatically applies to you.
4. Take care of your body.
For me, eliminating alcohol, improving my diet, keeping my bowel movements soft, and maintaining appropriate physical activity made the entire experience more manageable.
These things won't necessarily cure a fistula, but improving your overall health may help you cope with treatment and recovery.
5. Don't underestimate the psychological impact.
Constantly researching complications and worrying about every sensation took an enormous toll on me.
Understanding my diagnosis and developing a treatment plan helped me regain control.
Find medical professionals you trust and try not to let the condition consume every aspect of your life.
6. Advocate for yourself.
If your symptoms are persistent or worsening and you're not getting answers, seek appropriate specialist care.
If you can afford private healthcare and it helps you access timely investigations, consider it.
If you rely on public healthcare, explain your symptoms clearly, communicate changes, and ask whether your situation warrants an earlier appointment.
Seek urgent medical assessment for severe or rapidly worsening pain, fever, chills, or increasing swelling.
7. Don't give up hope.
This is probably the most important lesson I can share.
At certain points, I genuinely wondered whether I would ever feel normal again.
The pain and uncertainty were exhausting.
Yet in the week leading up to surgery, I was virtually pain-free.
That doesn't mean my fistula had disappeared, but it reminded me that my symptoms weren't necessarily permanent or destined to get progressively worse.
There are treatment options, and everyone's recovery journey is different.
FINAL THOUGHTS
Three months ago, I was hiking through Europe, experiencing unexplained pain throughout my pelvis and legs, and wondering whether something was seriously wrong with me.
Today, I've undergone fistulotomy, received reassuring investigations regarding inflammatory bowel disease, and had a precancerous colon polyp discovered and removed along the way.
It's been an incredibly strange experience.
In some ways, I'm grateful that it prompted me to investigate my health so thoroughly.
More importantly, it's reminded me how quickly your priorities can change when your health is affected.
I'm a business owner, and I'm fortunate to have considerable flexibility in how I organize my life.
Like many people, I spend a lot of time focusing on business, fitness, financial goals, and other responsibilities.
But when your health suddenly becomes uncertain, everything else starts feeling considerably less important.
You realize how valuable it is simply to wake up, feel comfortable, exercise, travel, and enjoy everyday life without constantly thinking about pain.
If you're currently struggling with a fistula, please remember that your present situation doesn't necessarily represent what the rest of your life will look like.
Find a good colorectal specialist.
Ask questions.
Look after your physical and mental health.
Get the treatment that's appropriate for your particular situation.
And most importantly, don't forget to enjoy your life in the meantime.
I'll update this post as I progress through recovery.
Wishing everyone dealing with this condition a successful treatment and recovery.