Anal fistulas are treated by our fellowship-trained colorectal surgeons, Dr. Yosef Nasseri and Dr. Moshe Barnajian — not by general practitioners. They bring sub-specialty colorectal training to every case, so the treatment is matched to your fistula, not to the one operation we happen to do.
Based in Beverly Grove at 8635 W 3rd St, Suite 880W, we care for patients across West Hollywood, Mid-City, Hancock Park, Beverly Hills, and the greater Los Angeles area. Learn more about Dr. Nasseri, Dr. Barnajian, and our colorectal surgery program.
The primary cause of an anal fistula is a perianal abscess—an infected cavity filled with pus located near the anus. When this abscess bursts or is inadequately treated, the pathway left behind may form a fistula.
Other causes and risk factors associated with fistula formation include:
Early recognition of fistula symptoms can lead to prompt treatment and better outcomes. Common symptoms include:
It’s important to distinguish anal fistula symptoms from hemorrhoids or other benign conditions. If you experience these symptoms persistently, consult a colorectal specialist to accurately diagnose and manage the condition.
Not all fistulas are the same, and the type you have is the single biggest factor in which treatment is right for you. Surgeons describe fistulas by how the tract relates to the anal sphincter muscles (the Parks classification), and as either “simple” or “complex.” Knowing your type is why two patients with “the same” diagnosis can be offered very different procedures.
“Simple” fistulas are low and involve little muscle; “complex” fistulas are high, branched, recurrent, or linked to Crohn’s. We confirm the type with examination and, when needed, MRI or endoanal ultrasound before recommending a plan.
Fistulas are common in Crohn’s disease, and they behave differently from ordinary fistulas: they’re more likely to be complex, branched, and prone to recurrence. We treat them with a combined, staged approach rather than a single operation.
That usually begins with an examination under anesthesia and placement of a draining seton to control infection and protect the sphincter, alongside medical therapy — including biologics — managed with your gastroenterologist. Definitive closure (often an advancement flap) is timed for when the disease is well controlled. The priority throughout is calming inflammation and preserving function, not rushing to close the tract.
Most anal fistula procedures are outpatient — you go home the same day. Recovery depends on the technique, but here’s the general picture:
Anal fistulas are one part of our colorectal practice. If you’re researching related conditions or want to meet the surgeons who would treat you, these pages are a good place to start.
Serving West Hollywood, Mid-City, Hancock Park, Beverly Hills, and the greater Los Angeles area from our office in Beverly Grove. Call (310) 861-7493 to schedule a consultation.
While minor anal fistulas might temporarily alleviate symptoms, they typically do not heal completely without surgical intervention. Persistent fistulas often require procedures such as fistulotomy or seton placement to ensure proper healing and prevent recurrent infections.
Neglecting treatment for an anal fistula can lead to chronic pain, recurrent abscess formation, and potential systemic infections. In some cases, untreated fistulas can result in the development of more complex tracts, making future treatments more challenging.
Patients with Crohn’s disease are more susceptible to developing anal fistulas. Managing fistulas in these patients requires a multidisciplinary approach, often combining medical therapies to control inflammation and surgical interventions tailored to the individual’s condition.
Post-surgical recovery can be supported by maintaining a high-fiber diet to ensure smooth bowel movements, practicing good anal hygiene, and avoiding prolonged sitting. Additionally, adhering to follow-up appointments is crucial to monitor healing and address any complications promptly.
No. A colostomy is almost never required for a routine anal fistula. It’s reserved for rare, severe, or complex cases — for example, extensive Crohn’s-related disease — and would be discussed with you in detail beforehand if it were ever considered.
It depends on the fistula and the technique. Simple fistulas treated with fistulotomy have very low recurrence (roughly 5% or less). Complex, sphincter-preserving repairs such as LIFT, advancement flap, and FiLaC have higher recurrence and occasionally need a second procedure. Your surgeon will give you a realistic estimate for your anatomy.
Protecting continence is the central goal of modern fistula surgery. For fistulas that cross significant sphincter muscle, our surgeons select sphincter-preserving techniques — seton, LIFT, advancement flap, or FiLaC — specifically to avoid incontinence. The risk is individualized based on how much muscle the tract involves.
A fistula typically drains pus or blood from a small opening in the skin near the anus and is often linked to a prior abscess. An anal fissure causes sharp pain and bleeding with bowel movements. Hemorrhoids cause painless bleeding, swelling, or prolapse. Because symptoms overlap, an in-person exam is the only reliable way to tell them apart.
Our colorectal surgeons offer the full range: fistulotomy for simple tracts, draining and cutting setons, LIFT, endorectal advancement flap, fibrin glue and bioprosthetic plug, FiLaC laser closure, and VAAFT. The right choice depends on how the tract relates to your sphincter muscles.
More importantly, our team of world-renowned surgeons have saved countless lives, and have enabled countless more to live healthy, happy lives.
Seeking care from Anal Fistula specialists is essential for effective management. Our dedicated team of doctors are experienced in anal fistula treatment, ensuring that you receive expert care tailored to your condition. We're here to answer your questions and guide you on your journey to better health.
