Here are the early signs of anal fistula that you should never ignore:

Persistent Pain or Discomfort Near the Anus:

Pain around the anus is the earliest symptom. It may be:

• Mild, throbbing, or burning pain
• Worsening while sitting, walking, or passing stools
• Persistent discomfort despite treatment for piles or fissures

Unlike piles, the pain of a fistula is more serious, localized to a particular spot, and may remain even in the absence of bleeding.

Recurrent Boils or Abscesses:

If you get:

• Frequent boils near your anus
• An abscess that bursts and heals but reappears at the same spot
• Pus discharge from the boil, followed by relief in pain

These are classic symptoms of a fistula. Many patients treat them as ‘normal boils’ with antibiotics, but recurrence indicates an underlying fistula tract.

Pus or Discharge Near the Anus:

If you notice:

• Sticky discharge staining your underwear
• Foul-smelling pus draining near the anus
• Persistent wetness or irritation in the anal area

This indicates an external opening of a fistula draining infected material.

Itching and Skin Irritation:

Due to constant moisture and discharge, the surrounding skin becomes:

• Itchy, inflamed, and red
• Sometimes develops secondary fungal infection
• Feels sore with a burning sensation

This is often misdiagnosed as a fungal infection or eczema unless properly evaluated.

Low-Grade Fever or Malaise:

If there is a continuous infection within the fistula tract, you may feel:

• Low-grade fever
• Fatigue and body aches
• Generalised unwell feeling

These symptoms indicate an ongoing infection requiring evaluation.

No Relief Despite Piles or Fissure Treatment:

If you are taking piles or fissure treatment (creams, sitz baths, medicines) but your pain or discharge does not resolve, consult a fistula specialist. Fistula is often misdiagnosed as piles in early stages, delaying proper treatment.