Fistula is a tract (passage) which communicates between two surfaces or body parts. Therefore it has two openings. Whereas, a Sinus starts from a surface and ends blindly without connecting to any other surface. Therefore, a sinus has only one opening. In case of an Anal Fistula, the two body parts which the fistula tract connects are the anus (rectum) lining and the skin (around the anus or buttock) . In cases of Peri-anal Sinus, the opening in the skin doesn’t connect to the anus (rectum). However, Peri-anal Sinus cases are not common and most of the times, such cases are Anal Fistula cases with a very small anal opening.

Anal Fistula is a dreaded disease. This is basically for three reasons 1. If the treatment is not done, the pus inside the fistula can spread further leading to formation of multiple tracts and several opening in the skin around the anus. This makes the fistula more complex and further difficult to treat. 2. Anal Fistula treatment is associated with high recurrence rate. A lot of patients who get themselves operated by routine surgeons have to undergo multiple operations to get cured. The lure of curing this disease without operation by quacks further complicate the treatment. Therefore, Anal Fistula should always be treated by an expert Colo-Rectal Surgeon who is proficient in dealing with Anal Fistulas. 3. Another important issue is that many surgeons are used to /comfortable doing a particular procedure for Fistula. They do the same procedure in all the patients. There are 5-6 procedures to treat Anal Fistulas and none of these procedures is perfect. Therefore, different procedure is indicated (should be done) in different patients, depending upon the type and complexity of that patient’s fistula. A single procedure cannot and should not be done in all the procedures. Very few surgeons are expert in doing all the procedures of Anal Fistulas. 4. There is a risk, though low, of cancer formation in the long standing Anal Fistulas. Therefore, Fistulas should always be treated at the earliest.