Devices for treating fistulas may include a cap with a vacuum port, a spacer with a lumen therethrough, a first distal anchor, and a second distal anchor. The devices may be configured to transmit negative pressure through the vacuum port, the spacer lumen, and an opening in the first distal anchor to releasably seal the first and second distal anchors to tissue, thereby securing the devices in place. The first distal anchor may also include a plurality of openings that form vacuum pathways that transmit the negative pressure. The cap may also include a flush lumen, which may allow flushing of a fistula tract without removal of the device. Methods of treating fistulas may include applying negative pressure to a fistula treatment device to anchor the device and flushing a tract of the fistula using a flushing fluid with the fistula treatment device in-situ.
