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Rectal abscess symptoms: Anal Abscess: Symptoms, Causes, and Treatments

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Anal Abscess: Symptoms, Causes, and Treatments

An anal abscess is a painful condition in which a collection of pus develops near the anus. Most anal abscesses are a result of infection from small anal glands.

The most common type of abscess is a perianal abscess. This often appears as a painful boil-like swelling near the anus. It may be red in color and warm to the touch. Anal abscesses located in deeper tissue are less common and may be less visible.

Surgical incision and drainage is the most common treatment for all types of anal abscesses and is usually successful.

About 50% of patients with an anal abscess will develop a complication called a fistula. A fistula is a small tunnel that makes an abnormal connection between the site of the abscess and the skin.

In some cases, an anal fistula causes persistent drainage. In other cases, where the outside of the tunnel opening closes, the result may be recurrent anal abscesses. Surgery is needed to cure almost all anal fistulas.

Causes of Anal Abscesses

An anal abscess can have many different causes. These include:

  • An anal fissure, a tear in the anal canal, that becomes infected
  • Sexually transmitted infections
  • Blocked anal glands

Risk factors for anal abscesses include:

For adults, using condoms during sexual intercourse, including anal intercourse, can help prevent anal abscesses. For infants and toddlers, frequent diaper changes and proper cleaning during diaper changes can help prevent anal fistulas and perianal abscesses.

Symptoms of Anal Abscesses

Superficial anal abscesses are often associated with:

  • Pain, which is usually constant, throbbing, and worse when sitting down
  • Skin irritation around the anus, including swelling, redness, and tenderness
  • Discharge of pus
  • Constipation or pain associated with bowel movements

Deeper anal abscesses may also be associated with:

Sometimes, fever is the only symptom of deep anal abscesses.

Diagnosis of Anal Abscesses

Usually, a clinical evaluation — including a digital rectal exam — is sufficient to diagnose an anal abscess. But some patients may require additional tests to screen for:

In rare cases, an examination may be done under anesthesia. The doctor may also ask for an ultrasound, a CT scan, or an MRI.

Treatment of Anal Abscesses

Prompt surgical drainage is important, preferably before the abscess erupts. Superficial anal abscesses can be drained in a doctor’s office using a local anesthetic. Large or deeper anal abscesses may require hospitalization and the assistance of an anesthesiologist.

After the procedure, most people are prescribed medications for pain relief. For otherwise healthy people, antibiotics are usually not needed. Antibiotics may be required, though, for some people, including those with diabetes or decreased immunity.

Sometimes, fistula surgery can be performed at the same time as abscess surgery. However, fistulas often develop four to six weeks after an abscess is drained. Sometimes a fistula may not occur until months or even years later. So fistula surgery is usually a separate procedure that can be performed on an outpatient basis or with a short hospital stay.

After abscess or fistula surgery, discomfort is usually mild and can be controlled with pain medications. People can expect to lose only a minimal amount of time from work or school.

People are usually advised to soak the affected area in a warm water (sitz) bath three or four times per day. Stool softeners may be recommended to ease the discomfort of bowel movements. Some people may be advised to wear a gauze pad or mini-pad to prevent the drainage from soiling their clothes.

Complications after surgery can include:

After an anal abscess or fistula has properly healed, it’s unlikely that the problem will come back. To prevent one from doing so, however, it’s important to follow the advice of your doctor or colon and rectal surgeon.

Abscess and Fistula Expanded Information

One of the most common diseases is rectal fistula. According to statistical data, approximately 95% of patients with rectal fistulas associate the onset of the disease with acute paraproctitis. In 30-50% of cases, after acute paraproctitis, a rectal fistula is formed in patients. A simple opening and drainage of the abscess without eliminating the entrance gate of the infection predisposes to the formation of a fistula of the rectum.Through the area of ​​the affected anal crypt or through the entrance gate of a different etiology (trauma), there is a constant infection of the pararectal tissues from the intestinal lumen. In the course of the fistula in the tissue with insufficiently good drainage, infiltrates and purulent cavities can form. Currently, we have developed and introduced into clinical practice various methods to avoid trauma to the muscular structures of the sphincter and the development of anal incontinence. Our specialists are proficient in all possible sphincter-preserving operations for rectal fistulas.

Fibrin glue

This technique is used in patients with rectal fistulas that involve less than 30% of the anal sphincter, a simple intervention technique, makes it possible to repeat the procedure, as well as the absence of a damaging effect on the muscle structures of the perineum. The technique has an advantage in patients with a high risk of developing anal sphincter insufficiency or with pre-existing anal incontinence.

Sealing pads (PLUG)

This method is used in patients with rectal fistulas.The biological material from which the tampon is made serves as the basis for obliteration of the fistulous tract. The low-traumatic nature of the operation, the lack of influence on the sphincter apparatus of the rectum gives an advantage over other techniques.

LIFT technique

(ligation and intersection of the fistulous tract in the intersphincteric space) .

The main purpose of the operation is to ligate and cross the part of the fistulous tract passing in the intersphincteric space. This method is used in patients with seizure of more than 1/3 of the sphincter.

VAAFT Technique

(Video-assisted rectal fistula treatment) .

The main feature of this technique is the absence of damage to the anal sphincter. The main stages of this technique are: visualization of the fistula using a fistuloscope, correct and accurate determination of the internal opening of the fistulous passage, detection of additional fistulous passages and leakage cavities under direct visual control, endoscopic treatment of the fistula and closure of the internal opening using a stapler or mucous flap.

This method is superior:

  • Lack of damaging effect on the sphincter;
  • Absence of large wounds, scar tissue deformation as a result of the operation;
  • Rapid recovery of working capacity;

Method of moving / transferring “high” fistulous tract into the submucosal layer or intersphincteric space.

Elimination of the fistulous tract in the intersphincteric space is a fairly simple and effective sphincter-preserving method of treating rectal fistulas.This technique is used in patients with transsphincteric and extrasphincteric fistulas.

Elimination of fistula using bioplastic material.

The advantages of using bioplastic material are to preserve the structures of the anal sphincters, by reducing the volume of surgical intervention in the area of ​​the internal and external anal sphincter. At the same time, the stage of isolation and transposition of a full-wall flap of the rectal wall is excluded, which reduces the operation time, and the use of a special guide allows for convenient and quick delivery of bioplastic material.