An anal fistula rarely heals on its own, and the right surgery depends on how complex the tunnel is. Dr. Zuri Murrell offers advanced anal fistula treatment in Los Angeles and Beverly Hills, including amniotic tissue and laser options for complex and recurrent cases that have failed elsewhere.

What Is an Anal Fistulas?

An anal fistula is an abnormal, tunnel-like connection between the inner lining of the anal canal or rectum and the skin near the anus. It usually starts as an infected gland or anal abscess that drains and leaves a tract behind.

Most fistulas have two openings, one inside the anal canal and one on the outer skin near the anus. Some have a single tract, while others branch into several, which makes them more complex to treat. Because the tract stays open, a fistula tends to cause ongoing discharge, irritation, and repeat infections, and it seldom closes without treatment.

Anal Fistula Symptoms

Only a colorectal surgeon can confirm an anal fistula, but common warning signs include:

Painful swelling around the anus
Pain during bowel movements
Anal bleeding
Discharge from an opening beside the anus
Irritated skin around the anus
Fever, fatigue, or chills in some cases

If these symptoms sound familiar, an evaluation with Dr. Murrell can pinpoint the cause and the best path to relief.

What Causes an Anal Fistula?

Most anal fistulas trace back to an untreated anal abscess. When the infection drains but the channel never fully closes, a fistula is left behind. Research shows that roughly half of anal abscesses eventually form a fistula.

Certain conditions raise the risk or make fistulas harder to heal, including:

Crohn's disease
Inflammatory bowel disease
Diverticulitis
Rectal cancer
Trauma, radiation, or prior surgery in the anal area

Fistulas linked to these conditions often call for the advanced options described below.

Advanced Anal Fistula Treatments for Complex and Recurrent Cases

Many patients come to Dr. Murrell after a fistula has returned or failed to heal under another surgeon. For these complex and recurrent cases, he offers two advanced, sphincter-sparing options that set his practice apart:

Amniotic tissue and Clarix, a biologic that supports the body's own healing
Laser treatment, which closes the tract from the inside with minimal muscle damage

Both protect bowel control while targeting fistulas that standard surgery struggles to fix. Dr. Murrell often pairs them with careful drainage and staged care for the best chance of lasting closure.

Amniotic Tissue and Clarix: A Stem Cell Recruiter for Hard-to-Heal Fistulas

One treatment that distinguishes Dr. Murrell's approach is his use of amniotic tissue, including a product called Clarix, during select fistula repairs. He describes amniotic tissue as a stem cell recruiter: a biologic graft that encourages the patient's own cells and natural healing response to close the tract.

Amniotic tissue is donated birth tissue, screened and processed into a sterile graft. It is rich in growth factors and anti-inflammatory proteins, and it contains no embryonic material. Placed into a cleaned fistula tract, it acts as a scaffold that healthy tissue can grow across while calming the inflammation that keeps a fistula open.

Why Dr. Murrell Uses Amniotic Tissue

Dr. Murrell reaches for amniotic tissue and Clarix when he wants to support healing without cutting through muscle, particularly for:

Complex or high fistulas that cross significant sphincter muscle
Fistulas related to Crohn's disease
Recurrent fistulas that did not heal after previous surgery
Patients who want to protect bowel control

Results vary by patient, and Dr. Murrell selects amniotic tissue only when the case fits. You can read more in his guide to amniotic tissue for complex anal fistulas.

Laser Treatment for Complex and Recurrent Anal Fistulas

For recurrent or persistent fistulas, especially those that have failed treatment elsewhere, Dr. Murrell offers a laser-based procedure that closes the tract from the inside. A thin laser fiber is passed into the fistula and delivers precise energy that seals the tract while sparing the surrounding sphincter muscle.

Laser fistula treatment is minimally invasive and tends to bring less postoperative pain and a faster recovery than open surgery. Because it avoids cutting across the muscle, it suits complex fistulas where protecting bowel control is a priority.

A True Laser Procedure

This is a dedicated laser treatment for fistulas, not an infrared or heat treatment used for hemorrhoids. Dr. Murrell uses it specifically to close the fistula tract, then monitors healing closely to lower the chance of recurrence and preserve anal function.

Standard Anal Fistula Surgery Options

For less complex fistulas, Dr. Murrell uses well-established, muscle-sparing techniques. After a thorough exam to map the tract, he explains which option fits your anatomy.

Fistulotomy

The most common procedure, used in roughly 85 to 95 percent of cases. Dr. Murrell opens the tract, flushes out the infection, and packs it so the fistula heals from the inside out.

Seton Technique

For larger fistulas where a fistulotomy could risk incontinence, a soft surgical thread called a seton is placed through the tract. It drains the fistula and encourages gradual, controlled healing while preserving muscle.

Bioprosthetic Plug

A cone-shaped graft made from human tissue is inserted into the internal opening of a high or complex fistula, avoiding any cutting of the sphincter. Tissue heals over the opening as the plug is absorbed.

Endorectal Advancement Flap

For complex fistulas that cross the sphincter, Dr. Murrell creates a flap of healthy tissue to close the internal opening from within, protecting continence.

Anal Fistula Surgery Risks

As with any surgery, anal fistula treatment carries some risks, which Dr. Murrell works to minimize:

Incontinence, mainly a concern with procedures that involve the sphincter
Recurrence, since complex fistulas may not fully heal on the first attempt
A new abscess forming during healing
A longer healing period for muscle-sparing techniques like the seton or flap

His preference for advanced, sphincter-sparing options is designed to keep these risks as low as possible.

Benefits of Anal Fistula Surgery

Treating a fistula properly offers meaningful benefits:

Relief from chronic pain, discharge, and irritation
Definitive healing that a fistula rarely reaches on its own
Preservation of the sphincter and bowel control with muscle-sparing methods
A return to normal, comfortable daily life

Why Choose Dr. Murrell for Anal Fistula Treatment in Los Angeles?

Dr. Zuri Murrell is a double board-certified colorectal surgeon and Director of the Colorectal Cancer Program at Cedars-Sinai. He is one of the West Coast surgeons specifically trained in minimally invasive colorectal surgery, and he trains other surgeons in advanced fistula techniques.

Patients travel to his Beverly Hills and Los Alamitos offices for complex and recurrent fistulas, including cases referred after failed treatment elsewhere. His use of amniotic tissue and laser therapy gives him tools many general surgeons do not offer, and his focus stays on healing the fistula while protecting your quality of life. See the areas we serve across the Los Angeles region.

Anal Fistula FAQs

Will an anal fistula heal on its own?

Rarely. Because the tract drains to the skin surface, a fistula usually will not close without treatment and can worsen over time.

What is the best treatment for a complex or recurrent anal fistula?

For complex or recurrent fistulas, Dr. Murrell often uses sphincter-sparing options such as amniotic tissue (Clarix) or laser treatment, sometimes combined with a draining seton. The right choice depends on the tract's anatomy and any underlying condition.

What is amniotic tissue, and how does it help a fistula?

Amniotic tissue is a biologic graft made from screened, donated birth tissue. Dr. Murrell describes it as a stem cell recruiter that encourages the body's own cells to close the tract. It contains no embryonic material.

Is laser fistula treatment the same as IRC for hemorrhoids?

No. IRC, or infrared coagulation, is an in-office heat treatment for internal hemorrhoids. Dr. Murrell's laser fistula treatment is a separate, true laser procedure that seals the fistula tract while sparing muscle.

What if my fistula came back after surgery elsewhere?

Recurrent fistulas are a focus of Dr. Murrell's practice. He reassesses the tract and its underlying cause, then tailors advanced treatment, which may include amniotic tissue, laser therapy, or a flap repair.

Where does Dr. Murrell treat anal fistulas?

Dr. Murrell sees patients at his Beverly Hills and Los Alamitos offices, serving patients throughout the greater Los Angeles area.

Schedule Your Anal Fistula Consultation with Dr. Murrell Today

If you have a fistula that will not heal or keeps returning, relief is possible. Contact Dr. Murrell's office to schedule a consultation and a personalized treatment plan built around lasting healing and bowel control.