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Accurate Diagnosis of
Anal Fistula

A fistula is like a tunnel with many branches. Unless the entire map is visible, surgery may fail. That is why accurate diagnosis using MRI Fistulogram is crucial.

Medically Reviewed by Dr. Jaya Maheshwari
Last Updated: Jan 2026

Diagnostic Methods

Step 1

Physical Examination

The doctor examines the external opening on the skin to see if there is pus or granulation tissue. A Digital Rectal Exam (DRE) helps feel the fibrous track.

Essential

Proctoscopy

A small tube is used to look inside the anal canal to find the 'Internal Opening' (the source of infection). Finding this opening is the key to cure.

Gold Standard

MRI Fistulogram

The Gold Standard. A specialized MRI scan that creates a 3D map of the fistula track, its branches, and its relation to sphincter muscles.

Alternative

Endoanal Ultrasound (3D EAUS)

An ultrasound probe inserted into the anal canal to visualize the track. Useful if MRI is contraindicated, but MRI is generally preferred.

Why MRI Fistulogram is Essential?

Old methods like X-ray Fistulography often missed side branches of the fistula. If a branch is missed during surgery, the fistula will come back (Recurrence). MRI provides a 3D roadmap for the surgeon.

FeatureMRI ScanOrdinary X-Ray
Track Mapping Detailed 3D View2D Shadow Only
Muscle Relation Clearly VisibleNot Visible
Accuracy 95-98%60-70%
Director's Interview

Diagnosing the Track

Physical Exam & MRI

"You cannot treat what you cannot see. The MRI acts like a GPS map for the surgeon before we even start the operation."

Dr. Jaya Maheshwari explains why she insists on an MRI for complex cases and how identifying the 'Internal Opening' is the secret to a permanent cure.

Vice President IAGES (2020–2022)
Trained in Germany & USA
Pioneer of Laser Proctology
Now Watching: Dr. Jaya on Advanced Treatments

Why Classify?

Diagnosis determines if your fistula is Simple or Complex. Using the wrong surgery on a Complex fistula can damage muscles and cause leakage.

Get a Second Opinion

Have an MRI report? Our experts can analyze the track and suggest the safest surgery.

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