An anal fistula that has continued for nearly 10 years with repeated pus discharge usually means the tunnel inside the skin has remained active and is not healing completely. This condition may improve temporarily, but it often comes back because the infection source inside is still present. Medicines or treatment should be taken only if advised or prescribed by your doctor. Warm sitz baths, good hygiene, avoiding constipation, and eating fibre-rich foods may help reduce discomfort and irritation. Drinking enough water and avoiding straining during bowel movements can also make symptoms easier to manage. Antibiotics or other medicines may sometimes reduce swelling or infection for a short time, but they usually do not remove the fistula completely. In long-standing fistulas, permanent healing without surgery is often difficult because the tract remains inside the tissue. Some minimally invasive procedures may be possible depending on the fistula type, so proper examination by a colorectal surgeon is important. Please seek medical care if pain, swelling, fever, or pus discharge becomes severe or frequent.