A 34 years old man was diagnosed as having an intestinal infection and anal fistula. Past history revealed, six years back patient was first time diagnosed and was operated by a surgeon and there was recurrence after three years and this time patient got treatment from Ayurvedic Medical college with medicated thread. This is third time patient has anal fistula with two internal hemorrhoids.
The patient is a smoker. What could be the cause of recurrence and appropriate line of action for this case? Please advise.
