There are several reasons why anal fistulas may recur after treatment. Let’s explore the most common factors that contribute to fistula recurrence:

• Incomplete Healing of the Fistula: One of the primary reasons for fistula recurrence is incomplete healing after surgery. If the entire fistula tract is not completely removed or properly treated, residual infection or inflammation can lead to the fistula reforming. This is why choosing a surgeon experienced in fistula management, like Dr. Samrat Jankar, is crucial.
• Complexity of the Fistula: Some fistulas are more complex than others, involving multiple branches or tracts, high anal locations, or deep tissue involvement. Complex fistulas are more challenging to treat and have a higher chance of recurrence if all of the tracts are not addressed during surgery. High anal fistulas, in particular, pose a challenge due to their proximity to the sphincter muscles.
• Infection or Abscess Formation: Persistent infection or formation of new abscesses near the site of the previous fistula can lead to recurrence. If the infection is not fully cleared during the initial treatment, the fistula may redevelop. Post-surgical infections or inadequate drainage of abscesses can also begin recurrence.
• Underlying Health Conditions: Patients with certain health disorders, such as Crohn’s disease or diabetes, are more prone to developing recurrent fistulas. Crohn’s disease, an inflammatory bowel condition, often causes chronic inflammation in the digestive tract, including the anus. This ongoing inflammation increases the likelihood of fistula recurrence.
• Poor Postoperative Care: Neglecting proper postoperative care can also improve the chances of fistula recurrence. After surgery, following the surgeon’s guidelines for wound care, hygiene, and medication is crucial for promoting healing and preventing infection. Inadequate care can result in complications and reformation of the fistula.
• Smoking and Lifestyle Factors: Smoking and certain lifestyle factors can negatively impact the healing process. Smoking, for example, lowers blood flow to tissues, delaying wound healing. A weakened immune system, poor diet, or lack of physical activity can also contribute to slow recovery and improve the risk of recurrence.
• Formation of New Fistulas: In some cases, the recurrence may not be the same fistula returning but the formation of a new fistula near the previous site. The development of multiple fistulas is common in patients with Crohn’s disease or persistent infections.