Answer box: An anal fistula (bhagandar) is a small tunnel between the inside of the anus and the skin nearby. It leaks pus or blood and keeps coming back, because medicines alone do not close the tunnel. Dr Raman Garg, surgical gastroenterologist at Bombay Gastro & Cancer Institute, Bathinda, Punjab, India, maps the tunnel, drains any pus and plans the right operation for you.
What is an anal fistula (bhagandar) in plain words?
Near the anus there are tiny glands. Sometimes one of them gets blocked and infected, and a pocket of pus forms. This is an anal abscess, which looks like a painful boil. When the abscess bursts or is drained, the infection can leave behind a narrow tunnel that joins the gland inside to a small opening in the skin outside. That tunnel is the fistula.
The tunnel does not heal by itself, because stool and germs keep entering it from the inside. So the opening on the skin closes for some weeks, then swells and leaks again. Many patients are treated again and again with antibiotics and creams, feel better for a while, and come back with the same boil.
Fistulas are described as simple (low) or complex (high). A low fistula passes through only a small part of the sphincter, the muscle ring that holds stool. A high or branching fistula passes through more of it. This matters, because the aim of surgery is to close the tunnel while protecting your control over stool. Dr Raman Garg is a surgical gastroenterologist, meaning a stomach, gut, liver, gallbladder and pancreas specialist who also operates, so one doctor assesses and treats the problem.
Symptoms and when to worry
- A small opening or boil near the anus that leaks pus, blood or a smelly discharge
- Repeated painful swellings at the same spot
- Pain that worsens when sitting, walking or passing stool
- Skin around the anus that is red, itchy or sore from the discharge
- Fever and chills when pus collects
- Stained underwear and a constant feeling of dampness
Red flags, go to a hospital the same day: a hot, red, throbbing swelling near the anus with fever (an abscess needs draining), severe pain that stops you sitting, diabetes with a sudden swelling, or spreading redness. An abscess is not a wait-and-see problem. Call +91 82641-60001 on the way.
People with diabetes, long-standing bowel inflammation such as Crohn's disease, or long loose motions have a higher risk. Fistula with weight loss, bloody diarrhoea or belly pain needs a gut check as well. See ulcerative colitis and Crohn's treatment.
Causes and risk factors
- A blocked, infected anal gland (the cause in most patients)
- An anal abscess that was drained but left a tunnel
- Crohn's disease, tuberculosis of the gut, or some infections, in a smaller number of patients
- Previous anal surgery or injury, including childbirth injury
- Diabetes and low immunity
- Long-standing kabz or loose motions
- Men aged 30 to 50 are affected more often, though women and young people get it too
A 38 year old truck driver from Dabwali who sits for 12 hours, has had two boils near the anus in a year, and now has a small opening that leaks is a typical case. He is often told it is piles. It is not, and the treatment is different.
How Dr Raman Garg diagnoses a fistula
The first visit is a private conversation and a gentle examination. Dr Raman Garg looks for the external opening, feels the tunnel under the skin, and judges how far it runs. A short scope check helps find the inner opening.
For complex or repeat fistulas, an imaging scan (an MRI fistula study) shows the exact route of the tunnel and its link to the sphincter muscle. This is arranged with trusted imaging partners in Bathinda, and Dr Raman Garg reviews the report the same day. If Crohn's disease or another gut disease is suspected, a colonoscopy is advised. See colonoscopy in Bathinda.
| Item | Starting (Rs) | Average (Rs) | Maximum (Rs) |
|---|---|---|---|
| OPD consultation | 500 | 700 | 1,000 |
| Colonoscopy, diagnostic (when advised) | 4,500 | 7,000 | 12,000 |
| Pre-operative blood tests, ECG and chest X-ray | 1,500 | 2,500 | 4,000 |
Note: These are typical Punjab costs for 2026. The final cost may vary after Dr Raman Garg examines you, depending on the number of tests needed and your health.
Treatment options: what works and what does not
Medicines alone do not close a fistula. Antibiotics and creams may settle the swelling for some time, but the tunnel remains. Honest advice is better than months of repeated tablets. Surgery is the usual way to treat a true fistula, and the plan depends on its type.
Step 1: Drain an abscess first. If there is a painful swelling with pus, it is drained quickly, often within hours of seeing the doctor. A drain gives relief and lowers the chance of the infection spreading. A fistula, if present, is treated at a planned second step.
Step 2: Choose the operation that matches the tunnel.
- Fistulotomy: for a low and simple tunnel. The tunnel is laid open and left to heal from inside out. Healing is usually good and the muscle involvement is small.
- Seton placement: a soft thread is passed through the tunnel to drain it and slowly guide healing, used when a larger part of the muscle is involved. Often part of a staged plan.
- Sphincter-saving procedures such as LIFT or advancement flap: for complex tunnels, to close the tunnel while protecting the muscle. Suited to selected patients.
- Treatment of the underlying disease, for example Crohn's disease, along with surgery where needed.
The key promise Dr Raman Garg makes is not a number but a method: the operation is chosen to close the tunnel and protect your control over stool, and he explains the trade-offs openly.
The procedure step by step
- Consultation, examination and scan review. You hear the plan, the options and the risks.
- Pre-operative blood tests, ECG and chest X-ray. Diabetes and blood pressure are brought under control first.
- You fast for 6 hours. A mild bowel-clearing medicine or enema is given.
- Anaesthesia: spinal or general, as suited to you.
- Dr Raman Garg finds the inner and outer openings, confirms the tunnel route, and performs the planned procedure. Most operations take 30 to 60 minutes.
- A dressing or a small drain is placed. You rest in a comfortable room.
- Most patients walk the same day, and many go home the same day or the next day.
- A written plan covers dressings, sitz baths, medicines and your follow-up dates.
Before and after: preparation, timeline and recovery
Preparation checklist
- Carry old reports, scans, medicine list and papers from any earlier drainage
- Tell us about diabetes, blood pressure, heart problems, allergies and blood thinners
- Fast for 6 hours before, with sips of water allowed until 2 hours before
- Bring a family member, loose clothes and pads for the dressing
Recovery timeline (most patients)
| When | What to expect |
|---|---|
| Day of surgery | Walking within hours. Soreness and some discharge are normal. |
| Day 1 to 3 | Pain medicines, first dressing changes, warm sitz baths. Stool softener and fibre. |
| Week 1 to 2 | Desk work for most patients. The wound is open on purpose, so that it heals from the inside. |
| Week 3 to 4 | Driving and lighter field work for most. Dressing needs decrease. |
| Week 6 to 8 | Wound healed for most patients with a simple fistula. Complex fistulas need more time and staged visits. |
The wound after a fistula operation is often left open so it heals from the base, and it can look worse before it looks better. This is expected. Dr Raman Garg checks it at each follow-up, which may be by phone or video photo for patients from far away.
Care at home: warm sitz bath 2 to 3 times a day and after stool, change the dressing as shown, take fibre and water, avoid straining, and keep the area clean and dry.
Risks and how they are handled
Possible risks include pain, bleeding, infection, the wound healing slowly, and the fistula coming back. Because the tunnel lies near the sphincter muscle, there is also a risk of weak control over gas or stool, which depends on how much muscle the tunnel involves. Careful assessment, a scan for complex cases, a staged approach with a seton where needed, and sphincter-saving methods are used to reduce this risk. Diabetes control and wound care help healing. Call us the same day for fever, heavy bleeding, new swelling or severe pain.
Cost of fistula treatment in Bathinda
| Item | Starting (Rs) | Average (Rs) | Maximum (Rs) |
|---|---|---|---|
| OPD consultation | 500 | 700 | 1,000 |
| Fistula surgery | 35,000 | 55,000 | 85,000 |
Note: These are typical Punjab costs for 2026. The final cost may vary after Dr Raman Garg examines you, depending on whether the fistula is simple or complex, type of procedure chosen, number of stages and your health.
Imaging scans are billed by the imaging partner. See all rates at gastro treatment cost in Bathinda.
Insurance and cashless treatment
BGCI is empanelled with almost all major insurers and TPAs for cashless treatment, including Aditya Birla Health Insurance, Niva Bupa, Digit Insurance, Care Health Insurance, Vidal Health TPA, ICICI Lombard, Raksha TPA, Future Generali, SBI General Insurance, Oriental Insurance, Liberty General Insurance, IFFCO Tokio, Cholamandalam MS, Medi Assist TPA, and almost all other major insurers and TPAs.
- Send your policy card and reports on WhatsApp +91 82641-60001.
- The insurance desk checks your cover and arranges pre-authorisation.
- You receive approval and a surgery date.
- After the procedure, the desk settles the bill directly with the insurer.
Ayushman Bharat: Call us with your card details and our insurance desk will tell you the same day how your card can be used. More at cashless insurance for gastro treatment.
Facilities at BGCI
- Private examination room for sensitive problems
- Modern operation theatre for planned and urgent procedures
- Advanced endoscopy and colonoscopy suite
- Fully equipped in-house diagnostic laboratory, including blood sugar and infection tests
- Imaging scans arranged with trusted imaging partners in Bathinda, reports reviewed by Dr Raman Garg the same day
- Comfortable patient rooms
- 24/7 emergency care support on +91 82641-60001
- Cashless insurance desk
- One surgeon from consultation to follow-up
- Online pre-arrival consultation for out-of-town and NRI patients through WhatsApp
- Follow-up by phone or video
See the gastro hospital in Bathinda page for more.
Why patients choose Dr Raman Garg for fistula
- 20+ years of experience and 10,000+ laparoscopic surgeries, so a senior surgeon plans your operation
- MBBS (Government Medical College, Patiala), MS General Surgery (DMC&H, Ludhiana), DNB Surgical Gastroenterology (Lilavati Hospital and Research Centre, Mumbai). Learn more about Dr Raman Garg.
- A repeat fistula gets a careful scan and a plan, not another course of tablets
- Dr Raman Garg also checks for gut diseases that cause fistulas
- One surgeon for the whole journey, and plain talk in Punjabi, Hindi or English
Patients we see from your area
Patients come from Raman Mandi (28 km), Mansa (50 km), Dabwali (55 km), Malout (60 km), Budhlada (65 km), Barnala (70 km) and other towns on areas we serve. Patients from the Sirsa and Muktsar side often plan a morning visit, tests and a quick plan the same day.
How to book
- Call or WhatsApp +91 82641-60001 or +91 99885-03800.
- Tell us about your problem and send any scan or earlier papers.
- Choose an OPD slot: Monday to Saturday, 10 AM to 5 PM.
- Visit Bombay Gastro & Cancer Institute, Power House Road, Near Street No. 10, Bathinda, Punjab 151001, India.
Emergency care support is available 24/7 on +91 82641-60001. Sunday: emergency only. Email: bgcibathinda@gmail.com. Use the book appointment page.
Related pages
Piles treatment | Anal fissure treatment | Blood in stool treatment | Ulcerative colitis and Crohn's treatment | Colonoscopy | Piles vs fissure vs fistula | All gastro treatments
This page is general information; your plan is set after Dr Raman Garg examines you.
Medically reviewed by Dr Raman Garg | Last updated: 8 November 2026