Expert medical and surgical care for anal fissures, fistulas, and perianal abscess — focused on pain relief and preserving normal bowel function.
An anal fissure is a small tear in the delicate lining of the anal canal, most often caused by passing hard or large stools. It typically causes a sharp, tearing pain during bowel movements, sometimes followed by a dull ache lasting hours, along with bright red bleeding. Fissures are extremely common and, while acutely painful, are highly treatable.
An anal fistula is an abnormal tunnel that develops between the inside of the anal canal and the skin around the anus — almost always the result of a previous perianal abscess that did not fully resolve. Unlike a fissure, a fistula rarely heals on its own and usually causes persistent or recurring drainage, irritation, and swelling until it is surgically treated.
Classic sign of an anal fissure, often with a lingering ache afterward
Bright red blood on tissue or in the toilet bowl, seen with both fissures and fistulas
Pus-like drainage or a small skin opening near the anus — a hallmark sign of a fistula
Painful lumps that come back repeatedly often indicate an underlying fistula tract
An acute perianal abscess needs prompt surgical drainage to relieve pain and control infection — this cannot be treated with antibiotics alone. Dr. Asad also evaluates and monitors drained abscesses for the possible later development of a fistula.
Dr. Asad also treats related anorectal conditions including pilonidal sinus disease and anal warts or benign anorectal lesions — ask during your consultation if these apply to you.
Fissure and fistula care is planned around one core priority: resolving the problem while protecting normal continence. For complex or recurrent fistulas especially, Dr. Asad favors sphincter-sparing techniques and, where needed, a staged surgical plan rather than a single aggressive procedure that risks bowel control.
Pain managed with medication and warm sitz baths; abscess drainage typically brings fast relief.
Wound care and dressing changes as fissure or fistula wounds heal gradually from within.
Full healing for most fistula tracts, which close by secondary intention over this period.
Many acute anal fissures heal with fiber, hydration, sitz baths, and topical medication within a few weeks. Chronic fissures that persist beyond 6-8 weeks despite these measures usually need a procedure such as sphincterotomy or Botox injection for lasting relief.
An anal fissure is a small tear in the lining of the anal canal, usually causing sharp pain with bowel movements. An anal fistula is an abnormal tunnel that forms between the anal canal and the skin, usually following a previous abscess, and typically causes persistent discharge, recurring swelling, or drainage rather than pain limited to bowel movements.
Fistula surgery is performed under anesthesia, so the procedure itself is not painful. Post-operative discomfort is generally manageable with pain medication and sitz baths, and is usually less than the pain of the untreated fistula or an abscess flare-up.
Dr. Asad prioritizes sphincter-sparing techniques such as the LIFT procedure and staged seton placement for complex or high fistulas specifically to protect continence. The right technique depends on how much sphincter muscle the fistula tract involves, which is carefully assessed before planning surgery.
Most perianal abscesses feel significantly better within days of drainage, with full wound healing over 2-4 weeks. Around a third of drained abscesses go on to form a fistula, which is why follow-up after drainage is important.
Book a consultation with Dr. Asad to discuss your symptoms and the right treatment path.
