Anal Abscess

ANAL ABSCESS pain

Last Updated December 20th, 2021

Overview

Since the anus is one of the orifices of the body communicating directly with the external environment, it is particularly vulnerable to infection. The glands, ducts, and lining of the anal canal are the usual sites of infection. An anal abscess usually develops when the anal glands get blocked or plugged with fecal matter, bacteria or foreign material which then collects in a cavity-causing irritation and inflammation.

These can easily appear in infants and young children if sufficient care is not taken to maintain hygiene during diaper changes. Among adults, sexually transmitted infections are also, at times, responsible for this often painful condition. Anal abscesses are not uncommon but since they are often spontaneously resolved, not all patients seek medical intervention.

 

Definition

Anal abcess dischargeAn anal abscess is a pus-filled cavity that is caused by infection of the cryptoglandular tissue of the anal canal. Externally, these manifest as tender, often painful reddish boils or lumps located around the rim of the anus. Less often, these are situated deeper in the tissue and do not present externally except in the form of fever.

The infectious agents usually implicated in this condition are a variety of common bacterial flora found in the gut and on the skin. Abscesses initially arise in the intersphincteric space of the anal canal and then spread outward from there, the infection spilling into one or more of the spaces surrounding the anal canal. They may drain spontaneously. Otherwise surgical incision and drainage is the preferred mode of treatment.

 

Causes

The primary cause of the anal abscess is an infection which may be contracted in a number of different ways including sexual intercourse or postoperative infection. Common aerobic and anaerobic bacteria such as Escherichia coli, Clostridium, Bacteroides fragilis, Staphylococcus aureus, and Streptococcus are usually responsible.

  • Blockage of anal glands can lead to infection and abscess formation.
  • Sexually transmitted infection.
  • Anal fissures are breaks in the skin surrounding the anus. These can be infiltrated by bacteria and become infected, developing into abscesses.
  • In rare instances, appendicitis can lead to supralevator abscesses. There are also certain risk factors that can increase the likelihood of an individual developing anal abscess:
  • Taking certain immunosuppressant medications.
  • Chemotherapy.
  • Constipation, since it can result in anal fissures.
  • Anal intercourse which can lead to anal fissures and infections if adequate protection is not used.
  • Inflammatory bowel disorders such as Crohn’s disease or ulcerative colitis.
  • Weakened immunity due to diseases such as HIV or AIDS.
  • Pregnancy.
  • Diarrhea.
  • Obesity.
  • Tuberculosis.
  • Anorectal or blood cancers.
  • Diverticulitis.

 

Symptoms

The telltale externally noticeable boils are usually easy to identify. However, when an abscess is located deeper within the tissues, as in the case of the supralevator variety, fever may be the only sign. The general symptoms of this condition are as follows:

  • Painful, reddish swelling in the area adjacent to the anus. This may be warm to the touch.
  • Rectal discharge that may be accompanied by bleeding.
  • Persistent throbbing pain in the anal region. The pain may be exacerbated by movement or by sitting.
  • Fever and chills.
  • Fatigue.
  • The difficulty with bowel movements or urination.
  • Sciatica and acute lower back pain may present in some cases of the supralevator abscess.
  • Infants may show signs of discomfort and irritability.

 

Types of Anal Abscess

ANAL ABSCESS painDepending on its specific location within the anal region, an abscess can be of four main types. Those that are located more superficially, such as the perianal kind, are by far more common. The ischiorectal variety is the next most common, followed by the intersphincteric and supralevator varieties.

  • Perianal: This accounts for nearly 60% of anal abscesses and results from the spread of infection to the area directly below the surface of the skin surrounding the anus. Tender, reddish lumps are externally noticeable and may be accompanied by some itching.
  • Ischiorectal: Infection spreads into the ischiorectal space of the anal region, with minimal external indications apart from some reddening of the skin surface and hardening of the underlying tissue. Symptoms such as fever, chills and severe pain are more common.
  • Intersphincteric: Infection remains confined to the intersphincteric space.
  • Supralevator: These account for only about 3-4% of the incidence of the anal abscess. They may be caused by the spreading of infection from intersphincteric or ischiorectal abscesses. They may even occur as a result of Crohn’s disease or diverticular disease.
  • Submucosal: 1% of all diagnosed cases are of this variety. Sometimes the abscess spreads in such a way as to partially encircle the area around the anus and this form is known as a horseshoe abscess.

 

Clinical Complications

Nearly half of all cases of anal abscess are found to progress into a chronic condition known as an anal fistula. A fistula is an abnormal tunnel connecting the abscess itself with the skin surrounding the anus. In the event of incomplete drainage of infected material during surgical treatment, the abscess can reappear soon afterward. Recurrent abscess formation commonly leads to the development of an anal fistula.If untreated or inadequately treated, infection from the abscess can spread to other locations and cause a systemic infection.

 

Diagnosis

A physical examination usually reveals the presence of the painful lump or boil characteristic of a perianal abscess. When they are more internally located, abscesses may be difficult to detect solely by means of physical examination. Anesthesia administered prior to examination aids the process by minimizing the patient’s pain and discomfort.

Digital rectal examination helps identify ischiorectal abscesses although intersphincteric and the rarer supralevator varieties generally only become apparent through diagnostic imaging. A computerised tomography (CT), magnetic resonance imaging (MRI) and anal ultrasonography help locate the abscess. associated fistulae if any and possible adverse effects on the anal sphincters or other internal structures. Screening for sexually transmitted diseases, inflammatory bowel diseases or other conditions such as cancer might be required to establish whether there is a causative relationship.

 

Treatment and prevention

Treatment – if it is a minor case if abscess, a local aesthesia can be given; and the abscess drained. In severe cases, a more intensive form of treatment may be needed –

  • Surgical drainage of the abscess and repair of the fistula.
  • Antibiotic treatment.
  • Placement of steton if continuous drainage is needed.

Preventions 

  • Manage diabetes.
  • Use a condom if you are partaking in anal sex.
  • In the cases of inflammatory bowel diseases such as Crohn’s, medication is usually provided to prevent abscess.

 

Dos and Don'ts

Dos
  • Sit in an 8-10 centimeter sitz bath 3 times a day and after a bowel movement. This helps with the pain and itching.
  • If you are prescribed with antibiotics, take them as directed.
  • Follow the doctors’ instructions if you are sent home with a drain or a package of the abscess.
Don'ts
  • Consume high-fiber foods; increase your fiber intake slowly.
  • Partake in any strenuous activity.
  • Skip your pain medications. If they do not work ask your doctor for different ones.

 

 

 

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Cottage cheese: What can you find in this healthy chunk of fresh milk cheese? Love cheese but scared of putting on extra pounds? With cottage cheese, you can get the best of…
Heart diseases patient
Heart Valve Surgery A heart valve surgery is a procedure to replace or repair the diseased heart valves. The most commonly…
Sputum test Sputum test is a commonly used diagnostic tool that is used to examine the presence of pathogens in…
Miracle extract from the root of maca: 10 ways it can help you! Maca root has been used for years in herbal medicine. Today scientific research is unearthing fresh evidence in…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
Vitamin K2: 8 reasons why you need this bone-building & cancer-fighting nutrient Vitamin K2 is claimed to be essential for your bone health, for reducing the risk of cancer, and…
Low fat diets
A complete list of low-fat diets and how to follow them Low-fat diets help you lose weight in a healthy way, but it works only with regular exercise and…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
black seed oil benefits
Black Seed Oil: What secret benefits could it bestow on your health? Black seeds or nigella seeds are tiny packets of health brimming with amazing benefits. Find out why should…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
angiography
Angiography Angiography is a diagnostic tool used to determine the narrowing or blockage in the arteries and veins supplying…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
Greek Yogurt: Discover the secret ingredient to the real Spartan strength Greek yogurt is probably the tastiest way you can enhance your gut microflora. Read more to find out…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
Potassium healthy
Potassium: How only 100 mg a day can dramatically increase your lifespan! The word potassium comes from the process where wood ashes were stored in pots for extraction. What else…
Blood Disorders cancer
Immunotherapy immunotherapy is a treatment that boosts the body's immune system to identify the cancer cells and fight cancer.
Lung cancer xray
Lobectomy Lobectomy is a surgery where a lobe of the diseased lung is removed. It is mainly done to…
heartfail_2
Open Heart Surgery An open heart surgery is a major procedure performed to treat heart diseases like congenital heart problem, heart…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
biopsy procedure
Biopsy Biopsy is a procedure of studying a live tissue sample collected from a specific organ for diagnosing a…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
What is Qigong and how can it help you channelize you inner “Qi”? Qigong is an integrated way of performing a traditional exercise regimen that can help in promoting health, mental…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
Period sanitary napkin-menstruaion-blood-colors
Period blood – what it says about your health Your period blood color and consistency indicate what is happening in your body. Is your blood bright red…
acne removal tips
Anatomy of acne: 7 instant steps to kiss those zits goodbye Blackheads, whiteheads, or pimples-call them what you may. Acne is never good news.Did you know some of the…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
Bronchoscopy procedure
Bronchoscopy Bronchoscopy is a procedure where in a scope is inserted into the lung pathway to observe any growth…
APL IgM Test
Antiphospholipid Antibody(APL)-IgM test The antiphospholipid antibodies are specific protein in the body directed against the phospholipids. It is used to detect…
Hibiscus: Nourish your beauty and health with these vibrant blooms Hibiscus is a trumpet shaped flower found abundantly in tropical countries. It has been historically used for its…
Pelvic_ultrasound
Pelvic Ultrasound Pelvic ultrasound is a process where sound waves are used to create image of your pelvic region organs…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
helping friend with depression
Support and care tips for helping people with depression Read to find out what is depression, its causes and symptoms. Also check out the steps describing how…

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