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Perianal Abscess in a Nutshell
“An anal abscess is a painful condition where there is a collection of pus which develops near the anus.” – Dr Ganesh Ramalingam
A perianal abscess may appear red and feel warm when you touch it. It is usually caused by infections of the small anal glands, which leads to pus collecting in the anal region. In some instances, the abscess is unable to heal, and tears open on the skin’s surface, which results in a painful anal fistula. The most common and effective way to remove perianal abscess is via surgical incision and drainage.
Most anal abscesses are the result of infection of the small anal glands. The most common type of abscess is a perianal abscess, often presenting as a painful boil-like swelling near the anus.
Sharing her experience about managing her perianal abscess, Brittany, a mother to a one-year-old daughter, explains the struggles she faced while managing her condition.
Brittany’s perianal abscess went undiagnosed by five separate physicians, extending her suffering and preventing her from taking proper care of her one-year-old daughter. Her condition was not helped as she struggled to find a doctor who would take her symptoms seriously.
Thankfully, Brittany finally found a doctor who was able to help her and treat her condition.
Certain risk factors increase your chances of developing a perianal abscess.
These factors are:
A perianal abscess is not limited to adults. They can also affect children and toddlers. This is usually observed in children with a history of anal fissures caused by constipation.
One of the most common symptoms of an anal abscess is the constant pain and throbbing in the anal region. This pain is usually accompanied by swelling in the anal area and may cause greater pain during bowel movements.
Other symptoms may include:
Some patients may experience a red, swollen lump that is tender to the touch at the rim of the anus. The infection can result in fever and chills.
You may also experience rectal bleeding or urinary difficulties.
Anal abscesses may also occur deeper in the rectum. Pus develops in the abscess and is more commonly observed in those who have inflammatory bowel diseases. This can result in some pain or discomfort in the abdominal area as well.
While there may be no definite ways to prevent an anal abscess, there are some measures that you can take, which includes:
While anal abscesses can lead to complications, most conditions are treatable. By understanding the risk factors and managing any health conditions that may increase the risk of developing a perianal abscess, you can seek medical advice from a doctor should you require early intervention and prevent them from becoming worse.
A perianal abscess is most often diagnosed by a physical examination of the affected area. Your doctor may check for pain, redness and swelling in the anal region while observing if further investigations are required.
In some instances of deeper perianal abscesses, where the signs are not immediately visible, an instrument called the endoscope may be used to look inside the anal canal and lower rectum.
Our doctor may also arrange for an imaging test such as a CT scan, ultrasound or MRI. This is such that a more accurate diagnosis can be made.
Further tests may be necessary to rule out the possibility of Crohn’s disease (a type of inflammatory bowel disease). In these cases, a blood test, imaging, and a colonoscopy may be required. Our doctor will use a lighted, flexible scope during a colonoscopy to examine your colon for other signs of growth or infection.
Complications of a perianal abscess may include:
In a lawsuit filed by a patient at Thomson Snell & Passmore, it was reported that the patient had to undergo nine surgeries after a hospital failed on two occasions to treat her perianal abscess with antibiotics and instead discharged her without treatment, leading to cellulitis (infection of the skin) and worsening of the abscess.
While the patient was treated for her condition by the end of the ordeal, the experience left her scarred.
Dr Ganesh: “It is important for medical specialists to exercise fair judgement when managing a patient’s condition. As with the case of the patient above, careful investigations have to be made when treating an abscess. Doctors may sometimes recommend several examinations to identify and diagnose a condition better.”
An anal abscess rarely goes away without proper medical treatment. As with most abscesses, the most common approach is for your doctor to drain the pus from the infected area. This can usually be done in the doctor’s clinic without the need for surgery. The affected region will be numbed before treatment, and any uncomfortable pressure should be relieved, allowing the tissue to heal correctly.
A perianal abscess left untreated can lead to severe complications such as the development of anal fistulas, which will require more surgical treatment. An anal fistula is an abnormal opening in the skin near the anus. This condition would need surgery to rectify the problem.
For cases where an extensive anal abscess is observed, our doctor may recommend surgery as a treatment option. In some cases, a catheter may also be utilised to make sure the abscess drains completely. Abscesses that have been drained are typically left open to heal and do not require stitches.
After surgery, our doctor may recommend some additional self-care advice to ease the pain, such as taking warm baths. Sitting in warm water will reduce the swelling and allow for more drainage of the pus in the abscess.
Antibiotics may also be prescribed if you have a compromised immune system or if the infection has spread.
Recounting his experience with what he calls an enormously painful perianal abscess, Brandon shares his story with Crohn’s & Colitis Foundation.
“In November of 2014, an enormously painful half-dollar sized perianal abscess took me by surprise. At the time, I had no idea what an abscess was,” Brandon recounts.
He was directed to a colorectal surgeon who attempted to cut and drain the abscess.
“After two surgical attempts, he surrendered to the uncontrollable buildup of fluid and passed me along to another surgeon.”
By then, his condition had worsened, the abscess had manifested into an intersphincteric fistula.
Perianal abscesses do not often go away without treatment. If left untreated, pus can build up in the anal or rectum, leading to more severe conditions such as anal fistulas, which are painful and require more extensive surgical treatment. It is estimated that 50 per cent of these abscesses develop into anal fistulas.
Surgery is the most common and effective method to drain abscesses completely to prevent discomfort for the patient. This is why it is essential to undergo prompt surgical drainage before the abscess erupts.
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I had to undergo an emergency surgery because the abscess on my bum was getting pretty bad. Dr Ganesh was detailed and wasted no time in treating me as I was in a lot of pain and honestly, I could feel pus coming out and it’s just disgusting, I just wanted it treated.
Dr Ganesh helped me get the abscess cleaned and drained and gave me some medication to recover at home. So far, I have been feeling much better and he did a great job so there was no scars or major pain.
Thank you Dr Ganesh.
I had severe food poisoning which resulted in a split in the skin near my buttocks. I was so shocked when I saw blood in the toilet thinking it was some terminal illness. Thankfully, after seeing Dr Ganesh, he diagnosed that I have an anal fissure and it can be treated quite easily.
I followed his advice to clean and improve my diet and within 2 weeks, I have fully recovered. Thank you Dr Ganesh!
Dr Ganesh is a trustworthy and caring doctor. I was hesitant at first to be seen as I noticed there was swelling and pus near my anus and wasn’t sure what to do. When I finally had to see a doctor, I found him online and I can see why people say he is friendly and patient. He managed to explain how I can get my condition treated without being difficult to understand.
I followed his advice and got him to treat me, it was surprisingly not as painful as imagined and he got the pus drained. Thank you to Nurse Jiaxin for helping to clean my wound as well.
Truly a great team and clinic!
I had a great experience with G&L Clinic. Dr Ganesh is professional and detailed in explaining to me about my condition, anal fistula. Apparently I had it without knowing until the pain was unbearable.
Because it was much more serious, I had to undergo a minor surgery for it. But following his advice, I am able to recover ahead of the time and am already back at work.
Thank you to Dr Ganesh, Lisa, Jiaxin, Ann and Angeline for being a wonderful, efficient team!
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