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Well it's a recurring fistula if you don't take care of it. Choice of Pathy is yours. I can only suggest mine. Surgery is an option here again. Other than that, lifestyle and diet modifications are required in your case. If you can do that. You won't need more surgeries.

Drink plenty of water....avoid spicy food ...bakery items...avoid constipation....eat fibers more...sit in warm water daily for 2 times...

Don’t fall on the gimic of ayurveda’s.Its totally doesn’t have any scientific proof.Its full of over dosage of steroids.For anal fistula surgery is the only option and post operative you must change your food habits to get rid of recurrence

These anal fistula are often recurrent, especially the horsesheo shaped once. It will demand a surgery once in every few months. You need to follow a proper diet, maintain a proper body weight along with medical aids and local ointment applications. Kindly reach out directly for further queries You can also visit me at my hospital for further discussion in person.

Need few more details for proper understanding of your issue. You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management

Surgery is the only option Take more of fibre and avoid constipation

Need few more details Kindly consult

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Hello, I went through the details you shared. From your MRI report it looks like there is still a fistulous tract present in the perianal region, though the inflammation has reduced compared to the previous scan. Fistula-in-ano is a chronic condition, and unfortunately, medicines or leech therapy alone cannot usually cure it completely. They may give some temporary relief, but recurrence is very common if the underlying fistula tract is not treated. The standard and most reliable treatment for fistula is surgery. The choice depends on the exact anatomy of the tract, your symptoms, and your surgeon’s judgment. Since your MRI also shows endometrial thickening with cystic changes, I would strongly suggest you also consult a gynecologist for that part separately.

I understand your concern. Your MRI shows that the fistula is complex, which explains why the abscess keeps recurring. This type of fistula does not usually heal with ayurvedic or leech therapy, so it’s best not to delay proper treatment. Please continue with sitz baths to keep the area clean and take antibiotics if there is pus. In such cases, advanced minimally invasive options like laser (FiLAC) or VAAFT are safer and more effective than repeated conventional surgery. Also, your doctor may need to rule out conditions like Crohn’s disease or TB before final treatment.

It's a complex fistula. Don't be in a hurry to operate. There are multiple submucosal branches as seen on MRI. The Abcess recurs and is common in this case. Please avoid any unproven management protocols. In cases of such complex fistulas we need to rule out crohn's and TB. Kshar sutra will not be helpful as it is complex branching fistula.

  Go for any therapy  its a recurrent  disease.

The management of fistula is surgical. It often reoccur that being said happened in your case.

Medication only gives you temporary relief so surgery is most important for permanent treatment . Also leech therapy can cause you infection or other problems . I strongly advised u for surgery because it is better option

Avoid fried food and spicy food and Water intake more Green leafy vegetables and fruits Fiber meal Do connect and consult

Can help you, kindly consult and provide detailed history for proper diagnosis and further management