Crohn’s disease – Living with an anal fistula

Crohn’s disease is an inflammatory bowel disease that may affect any part of the digestive tract down to the anus.

A frequent condition

An estimated third of people living with Crohn’s disease may develop a fistula. An anal fistula is a channel / passage that connects the bowel (the anal canal) with the skin.

Symptoms of anal fistulas may include:

  • Skin irritation
  • Pain, usually getting worse at bowel movement or coughing
  • Leakage of bowel matter

Treatments of anal fistulas can be medically, surgically or a combination of both.

Surgical treatments of fistulas depend on the exact type of fistula, i.e. it’s location and complexity. Your treating surgeon will explain the different options to you. Unfortunately, there is no guarantee that closing of the fistula is successful. High recurrence rates are reported in literature.

Risks are also associated with surgical treatment, especially for high fistulas, – including incontinence of treated patients.

To avoid incontinence, more invasive surgery in some cases may be replaced by the placement of a loose “seton drain”.

A seton* drain is a synthetic thread (frequently made of silicone) that is passed through the fistula and out through the anus. It is then tied together in a knot to stay in place.

Knots of conventional seton drains can cause a few symptoms:

  • Burning sensation
  • Pruritus
  • Perianal discomfort

An improvement of loose seton drains was made in recent years. Comfort Drain, a knotless seton drain is now available for patients.

A comparative study from a university hospital in Vienna, Austria, has shown significant improvements for patients. **

Significant advantages of Comfort Drain when compared to traditional seton drains are remarkable:

  • Improved quality of life of patients
    (mental and physical)
  • Less burning sensation
  • Less pruritus
  • Less perianal discomfort

Patient with two different seton drains in situ.

Traditional seton drain vs. the knotless Comfort Drain


For more information about the availability of Comfort Drain in your country, you can contact the manufacturer
(A.M.I. – Agency for Medical Innovations): 

* seton (from the Latin seta, “bristle”)
** Kristo, I. et al., (2016), The type of loose seton for complex anal fistula is essential to improve perianal comfort and quality of life. Colorectal Dis, 18: O194–O198.