Anal fistulas: causes, symptoms, treatment & care with an intimate shower
Anal fistulas are among the most common proctological conditions and, left untreated, can cause serious discomfort. Here you'll learn everything about the causes, symptoms and treatment options – and why an intimate shower is a particularly gentle and effective way to care for anal fistulas.
“Caring for the buttocks and anal wounds is significantly easier with a bidet shower, as it makes cleaning inflamed skin conditions much simpler.”
– Dr. Daniel Paul Sterzing, Specialist in Proctology
What are anal fistulas?
An anal fistula is an abnormal, inflamed connecting channel in the area of the anus, often originating from an abscess. It usually develops from a tear in the anal skin and mucous membrane that fails to heal and turns into a chronic, painful fistula tract.
Typically there is a recurring ulcer, often at the back of the anus (towards the tailbone). The poor wound healing is often down to poor blood flow, caused by increased resting pressure of the sphincter.
Typical symptoms of anal fistulas
- Sharp, burning pain during or independent of bowel movements
- Bleeding during bowel movements
- Anal cramps from muscle tension
- Itching in the anal area
- Visible skin folds at the fissure
These symptoms can seriously affect your quality of life and should be checked by a doctor.
Causes of anal fistulas
The main cause of an anal fistula is a build-up of pus (an abscess) in the anal area. This often results from a bacterial infection of the proctodeal glands, which sit between the inner and outer sphincter.
Over time a fistula tract forms, draining the pus to the outside. Without treatment this tract remains and causes ongoing discomfort.
Treatment options for anal fistulas
1. Conservative therapy
- Medication to lower sphincter pressure
- Sphincter dilation to improve blood flow
- Use of local anaesthetic ointments
- Encouraging soft stools through a high-fibre diet or stool softeners
2. Surgical removal
In advanced cases, surgical removal of the fistula may be necessary. After surgery, careful anal care is essential to support wound healing and prevent recurrence.
Gentle anal care with an intimate shower
The right care is crucial – especially after surgery or with an existing fistula. Instead of harshly wiping with toilet paper, clean the anal area gently with water. An intimate shower (also known as a butt shower) offers these benefits:
- Thorough but gentle cleaning without friction
- Avoids skin irritation and infection
- Supports natural wound healing
- Ideal for people with sensitive or inflamed skin
Tip: Use only clear, lukewarm water – skip soaps and perfumed products.
Toilet stool: a natural way to make going easier
Another tip for easing the discomfort of anal fistulas is to use a toilet stool. It puts you in a squatting position, which means:
- the angle of the bowel is optimised
- bowel movements are easier and more complete
- unnecessary pressure on the anal area is avoided
Especially after surgery or with chronic complaints, a toilet stool supports natural digestion and takes the strain off the sensitive anal area.
Frequently asked questions about anal fistulas
An anal fistula is an inflamed connecting channel in the area of the anus, usually caused by an abscess, that leads to chronic discomfort.
Typical symptoms include burning pain during bowel movements, bleeding, itching, anal cramps and visible skin changes in the anal area.
Anal fistulas can be treated conservatively with medication and ointments, or surgically. The right care is crucial for how well they heal.
An intimate shower allows thorough but gentle cleaning without friction, which supports wound healing and prevents skin irritation.
A toilet stool improves your position during bowel movements, reduces pressure on the anal area and supports complete emptying of the bowel.
