Anal fissure and anal fistula are two different anorectal conditions, but many patients worry about whether one can lead to the other.
This concern is understandable because both problems cause pain, discomfort, and can seriously affect daily life.
The short answer is: yes, in certain situations, a fissure can indirectly turn into a fistula, though this is not very common.
Understanding how and why this happens can help you seek timely treatment and avoid complications.
How Can a Fissure Turn Into a Fistula?
A fissure does not directly change into a fistula, but complications can connect the two conditions.
When a fissure remains untreated for a long time, it can get infected. This infection may spread to nearby anal glands, leading to the formation of an abscess. If this abscess does not heal properly, it can create a tunnel between the anal canal and the skin — resulting in a fistula.
So, the progression usually looks like this:
Chronic fissure → infection → abscess → fistula
This is why persistent fissure pain, swelling, or discharge should never be ignored.
What Is an Anal Fissure?
An anal fissure is a small tear or cut in the lining of the anal canal, usually caused by hard stools, constipation, or straining during bowel movements.
What Is an Anal Fistula?
An anal fistula is an abnormal tunnel that forms between the anal canal and the skin around the anus, most commonly developing after an infection or abscess in an anal gland.
Warning Signs That a Fissure Is Getting Complicated
While most fissures heal without trouble, you should be cautious if you notice pain that does not improve over weeks, pus or foul-smelling discharge, swelling near the anus, fever, or repeated infections. These symptoms may indicate abscess formation or fistula development.
Early medical evaluation at this stage can prevent the need for more complex treatment later.
Can This Progression Be Prevented?
Yes, in most cases it can. Early treatment of fissures is the key. Maintaining soft stools through a high-fiber diet, adequate water intake, and avoiding excessive straining helps the fissure heal naturally. Medications that reduce anal sphincter spasm and improve blood flow also play an important role.
Once infection sets in, medical or surgical intervention may be required to stop further progression.
Final Thoughts
A fissure turning into a fistula is possible but uncommon, and it usually happens only when a fissure is neglected or repeatedly infected. The good news is that with early diagnosis and proper treatment, both conditions are highly manageable.
If you are dealing with ongoing anal pain or symptoms that are not improving, consulting a specialist early can save you from long-term complications and invasive procedures later on.