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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Pelvic Ultrasound Pelvic ultrasound is a process where sound waves are used to create image of your pelvic region organs…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
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…
18 instant steps to make your jogging routine more powerful Jogging is a form of Aerobic Endurance training which includes running at a slow pace. Jogging is slower…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
blood elements analysis
Vitamin Profile Your doctor will recommend you undergo the vitamin profile test if you are showing signs of either vitamin…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
kidney stones
Kidney stones Kidney stones are solid substances made up of crystals. They can be of various sizes. Treatment depend on…
complement c4 test
Complement 4 (C4) Test The Complement 4 or C4 test measures the level of the protein in the bloodstream, and is primarily…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
toxo gondii igm test
Toxo Gondii-IgM Test The toxo gondii IgM test is a blood test that tells the presence or absence of toxoplasmosis IgM…
anti-chlamydia antibody tets
Anti-Chlamydia Antibody -IgG Test Anti-Chlamydia Antibody - IgG test is performed by collection of urine or genital fluids as sample for testing…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
free psa test
Free PSA Test The free PSA test is used to detect the level or percentage of free PSA in the body…
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…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
stain blood
Blood in your stool Know the reason for blood in your stool, toilet bowl or tissue and the important steps to take…
Lauric Acid: 8 health benefits you can derive from coconuts Appropriate use of saturated fats containing lauric acid can provide you numerous health benefits. This is the main…
piles
Best treatment for piles in Bangalore All you need to know about piles and piles treatment in Bangalore - the types of treatment available,…
PREGNANCY
Pregnancy During pregnancy, the body undergoes a number of biological and physical changes to accommodate and provide for the…
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
Crossfit with rope
CrossFit: Now get the perfectly sculpted body with this explosive gym routine CrossFit is a fitness regimen that makes use of high-intensity exercises in a shorter period to achieve muscle…
Krill Oil: Does the solution to human illnesses really lie at the depths of the ocean? The word "krill" means “small fry of fish” in Norwegian. They are usually the primary food source of…
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…
Hot cups for detox? Read all about the ancient technique of cupping Did you know inverted hot cups on your back can squeeze out and eject toxins from your body?…
yoga health benefits
How to practice yoga for astounding health benefits Can a 5000-year-old system be the ultimate body healer? Did you know yoga can make you smarter and…
50 common health conditions
What are the top 50 deadly and widespread diseases? A complete list of the top 50 most common and deadly diseases that plague humanity. Which disease is…

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